The need for Personalised Care when choosing Premium Lenses
During cataract or refractive intraocular surgery (where the crystalline lens is replaced even though it is not affected by a cataract), the ophthalmologist has to implant an intraocular lens to replace the crystalline lens.
For years, the process which was carried out before the operation, only involved a calculation of the dioptres required in the intraocular lens to try to correct the main refractive defect. Once operated on, patients normally had to use spectacles to correct the residual refractive defects in distance or near vision.
Today there are many more possibilities than before for improving visual quality after the operation. Therefore the quality of vision of the patient after surgery is largely determined by the type of lens selected; its functionality and the characteristics of its optic (the part of the lens you see through). The possibility of personalising and individualising an Intraocular Lens can in many cases guarantee independence from spectacles after the procedure.
As a result, it is now possible to choose a special (and practically specific) intraocular lens for each patient based on their needs. This has been a real revolution and paradigm shift (the focus of the intraocular lens market has changed). As well as performing high precision tests and measurements, it is also important to consider which option best caters for the patient’s lifestyle and expectations.
Advantages of different types of Premium Intraocular Lenses
The vast majority of Intraocular Lens implants are performed when the crystalline lens has a cataract or with a view to correcting tired sight. Unlike Standard Intraocular Lenses, which by offering a single focal point are unable to eliminate dependency on spectacles, nowadays many types of Premium Intraocular Lenses are available which have various focus areas and which, thanks to their different optical principles, can in most cases take away the need to use spectacles or contact lenses.
For patients who use progressive spectacles and are considering intraocular surgery, there are now HD (High Definition) Intraocular Lenses with fewer side effects (e.g. halos). For patients with a certain degree of astigmatism or specific retinal conditions, the intraocular lens can incorporate a correction for astigmatism or special filters for retinal protection. Also available are IOLs which are implanted as an Add-On lens, which can be used for patients who already have an artificial lens but who would like the residual refractive defect (where this is the case) to be corrected. Another option available is the Light Adjustable Lens (LAL), which can have its dioptres modified after implantation, providing for total personalisation. To summarise, there is no longer a single lens with a single focus, but a wide range of lenses with different characteristics which can cater for specific requirements in an optimum way.
In short, Premium Intraocular Lenses make it possible for patients to have an intraocular lens implanted which is best suited to their needs, expectations and lifestyle.
Different Types of Premium Intraocular Lenses
In simple terms, we could classify Premium Lenses into the following groups:
- Aspheric Intraocular Lenses (HD)
- Toric Intraocular Lenses (for the correction of astigmatism)
- Multifocal Intraocular Lenses
- Intraocular Lenses with a Filter for Blue Light (yellow lenses)
- Add-On Intraocular Lenses
- Phakic Intraocular Lenses
Aspherical Intraocular Lenses – High Quality Vision
Unlike traditional intraocular lenses (spherical monofocal), an aspherical intraocular lens does not induce optical errors (high order aberrations), and can thereby generate optimum visual acuity with the best vision in terms of contrast and colour.
The differences between this lens and the standard version are especially noticeable in night vision and situations with poor lighting, as aspherical lenses reduce aberrations (visual distortions). In clinical studies, an improvement has been noted in road safety when driving in adverse weather conditions thanks to the driver’s improved vision (quicker reactions). This improvement in vision is obviously significant and noticeable in many other activities: sports, viewing works of art, etc.
Besides the aberrations induced by traditional intraocular lenses (spherical) there are also minor aberrations produced by the eye’s own optical system. Thanks to aspherical lenses these small errors can be corrected in a personalised way. This solution allows for aberrations to be measured before implanting a personalised lens to correct them. It thereby contributes to obtaining the best possible vision in each eye after surgery.
Toric Intraocular Lenses – Correction of Astigmatism
As well as myopia, hypermetropia and presbyopia, the patient may display a certain degree of astigmatism; Toric intraocular lenses have been created to correct this. Therefore, thanks to Premium Toric lenses, we are able to say that all refractive defects can now be corrected in a single operation.
As regards their calculation, toric intraocular lenses are calculated in a personalised way for each patient and can even be manufactured expressly for a specific case. On some occasions toric IOLs are not used to correct astigmatism, instead opting for a corneal laser treatment.
Multifocal Intraocular Lenses – Distance and near vision
Standard Multifocal Lenses enable good distance vision, but near vision is blurred and the use of reading glasses is required.
Modern Multifocal Intraocular Lenses, on the other hand, offer good vision at distant, intermediate and near distances. This independence from spectacles results in a major improvement in quality of life in many situations (in addition to the comfort of not wearing glasses, many patients opt for multifocal intraocular lenses for aesthetic reasons).
Depending on the intraocular lens manufacturer, there are many different designs and technologies, all with their respective advantages and disadvantages. For example, there are multifocal lenses with concentric refractive areas or lenses with an asymmetric sector clearly differentiated for near vision. At nuevocristalino you can find all the models which your ophthalmologist has available for you. He will agree with you on the intraocular lens which suits you best.
Intraocular Lenses with a Filter for Blue Light – Protection of the Macula
Blue light (which forms part of the light spectrum produced by sunlight) is potentially harmful to the macula because it contains frequencies of high energy. In the case of a healthy eye, the macula is protected against this Blue Light thanks to the crystalline lens’ natural filtering characteristics. After removing the crystalline lens, this natural protection is lost. This is where Intraocular Lenses with Filters for Blue Light come in, as their protection offers patients with AMD or diabetes increased security.
Phakic Intraocular Lenses
In some cases, patients are not suitable candidates for corneal laser surgery and have a healthy crystalline lens. Phakic intraocular lenses offer a good solution for correcting the refractive defect, as they are implanted without removing the natural crystalline lens and without modifying any other ocular structure.
There are two types of phakic intraocular lenses: ICL and Verisyse. Your ophthalmologist will advise you on which is the best for correcting your refractive problem.
Add-On Lenses: The option of a life without spectacles also available to patients who have already had cataract surgery.
After cataract surgery there are situations where the use of spectacles is still necessary. Despite the fact that calculation of an intraocular lens is very precise in most patients, in some cases the anatomy differs from that obtained in the measurements, resulting in a different distance to that calculated between the lens and the cornea. The result is a residual refractive defect.
An Add-On lens is implanted as an additional lens in the eye to correct this residual defect. Therefore, with an Add-On lens it is possible to correct not only myopia, but also hypermetropia and astigmatism.
Additionally, if a patient has had cataract surgery with a monofocal lens for distance vision and would now like to stop using spectacles for near vision, they have the option to have an Add-On lens implanted, even several years after the first operation. Add-On lens implants are reversible if a change is experienced in the ocular refraction (it can be replaced if for example there is a change in the refraction of the eye).
Add-On lens calculations are very precise as they are normally very small values and the position of the lens is easier to calculate.
Frequently Asked Questions about Premium Intraocular Lenses
What are Premium lenses?
During cataract or lens replacement surgery to correct ametropia or presbyopia new intraocular lenses are implanted, which can be either standard or premium – individually customised to your needs.
What is a multifocal lens?
The multifocal intraocular lens displays more rings with different refractions. It projects vision for near and distance on the retina. By distributing the entry of light into more focuses, the multifocal lens enables vision at all distances. The brain learns to choose the correct area of vision so that, thanks to multifocal lenses, life without spectacles can become a reality.
What type of multifocal lens is best for me?
The choice of multifocal lens is very personal. Find out about the many different models on this site. Learn from the experiences of other patients on our forum. Speak to your ophthalmologist about which type of lens would be best for you. Find out which doctors have the most experience with multifocal lenses and implant them routinely. Our lists of ophthalmologist and comments from other patients will be extremely useful to you.
What is the probability of not needing spectacles after having multifocal lenses implanted?
With the help of modern multifocal lenses over 90% of patients can see clearly for near and distance or they can do without their glasses for 90% of the day.
Do I need to get used to multifocal lenses as is the case with progressive spectacles?
The way that multifocal lenses work optically is totally different to the case of progressive spectacles. If you are unable to always comfortably wear progressive spectacles, this does not mean that you are not a candidate for multifocal lenses. Many patients can see clearly at all distances shortly after the operation. Some require 1-3 weeks to become accustomed to multifocal lenses.
Are there side effects with multifocal lenses?
Some people suffer glare or halo effects which can be caused by multifocal lenses. Normally the brain is capable of neutralising these phenomena after an adaptation period. In most cases, these are not of major concern, because the quality of life without spectacles is much better.
Are multifocal lenses suitable for everyone?
In addition to medical reasons, there are some professions for which other premium lenses are more suitable – e.g. for professional drivers who have to drive at night, HD lenses are recommended due to their advantages especially in night vision. In general, multifocal lenses can improve your quality of life, because spectacles no longer needed. In some situations spectacles may still be required, e.g. when reading for a long time in poor, insufficient lighting. These aspects are very important for patients to be aware of and to enable them to choose the best solution.