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July 22, 2020 | Author: Admin
Cataract surgery with an intraocular lens or IOL as it is commonly called has the potential to improve a patient’s vision and refine the patient’s visual result to a given target. Usualmonofocal (i.e single distance) IOL’s are limited in their range of vision, typically achieving distance, intermediate, OR near, but rarely encompassing all distances.
Accommodation, is a unique property of the young transparent lens which allows us to focus for both distance and near vision. This is generallylost as the person ages or following cataract surgery where in the natural lens is replaced with a monofocal lens. The ideal Intraocular Lens would not only restore the patient’s vision but also allow the patient to regain his or her ability to see at all distances.
We routinely use the Presbyopiacorrecting lenses (IOLs) for our patients. These include Multifocal IOLs, Bifocal IOLs, Trifocal IOL’s. As the name suggests, these lenses have the unique property to enable two or more clear foci hence provide spectacle independence for both near anddistance vision.
It is challenging when choosing presbyopic IOLs to achieve spectacle independence. This IOL is carefully chosen by the surgeon depending on the inherent anatomy and physiology of the eye. A detailed assessment of lifestyle and personality dynamics of each patient is made by the surgeon.
Accurate preoperative diagnostics are an essential prerequisite to planning these premium IOL’s.We, at Ojas have incorporated all the mandatory tests prior to selection of such a multifocal IOL.We, at OJAS have the IOL Master 700( Zeisstechnologies ) , the most advanced, one of its kind biometer device which measures the length of eye and corneal curvature with great precision. It helps us calculate the astigmatism or cylinder value of patient’s eye. This helps us plan an appropriate multifocal ( i.etoric multifocal for those with higher cylinder readings ) IOL for best visual outcome. We use the Pentacam HRTopography which is the gold standard for measuring corneal dimensions ( both front and back surface ). Another important mandatory test is retina check up after dilatation. A microscopic evaluation of the central part of the retina with the OCT ( Ocular Coherence Tomography ) is also performed at Ojas to validate good macular function. After all these individualistic and detailed patient assessment, our expert Cataract team calculates with the help of appropriate and complex formulae the lens power for each eye for best results.
Our goal is to create a happy satisfied patient with the appropriate IOL technology. Bifocal IOL’s have clear vision at both near and far distance enabling most to carry out all activities without glasses. Another excellent lens is the Diffractive Trifocal IOL (AT LISA trifocal IOL, FineVision trifocal IOL, and Panoptix ) which provides excellent vision for far, intermediate and near distances.
Few patients may report glare and haloes post operatively, but these are minimised with proper counselling before the surgery and resolve subsequently with neuroadaptation ( which is an automated self adjustment by the eye and brain and wiring between the two).
We also have the option of Extended depth of vision ( EDOV ) lenses like the Symfony which allow good distance and intermediate vision, but slightly compromised near vision and very less glare and haloes.
At Ojas, we ensure best results for all distances with premium Multifocal IOL’s with appropriate selection of patients. Now, with cataract surgery one can really be young again and live without glasses.
Contributed by Dr Rushita Kamdar
Cornea, Cataract and Refrcative Consultant ,
Ojas Eye Hospital, Mumbai.
