Rejuvinate Your Eyesight !
see near, see far & rediscover youthful eyesight
The natural extension of customised cataract surgery is the application of advanced lens implants to reduce or eliminate the need for reading spectacles following cataract surgery. There are two main ways in which reading spectacle dependancy can be reduced or eliminated using lens implants - Monovision or BIFOCAL lens implants.
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Monovision
The simplest approach is by targeting one eye to become the near viewing eye whilst targeting the 'dominant' eye to act as the distance viewing eye. This approach - called monovision - can be considered in around one third of all patients who wish to be less dependent on both distance and close vision glasses. This approach required a careful evaluation to firstly determine which eye can be designated the distance eye and secondly how adept your visual system is in making full, comfortable use of the monovision approach. For patients who are able to demonstrate good adaptability to monovision it can be a very good way of eliminating ro reducing the need for both distance spectacles and reading spectacles. You can learn a little more about monovision in the Presbyopia section too.
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Bifocal / Multifocal Lens Implants
A more sophisticated approach to monovision that works well for many of my patients is to take advantage of the latest generation of BIFOCAL lens implants. Such precision engineered lens implants can successfully provide excellent distance and near vision without the need for glasses. Please note that many lens implant manufacturers refer to these implants as MULTIFOCAL - but in general most of these implants have two clear focal points - and thus BIFOCAL is probably a more accurate term.
I have access to and experience in using a very wide range of bifocal lens implants, encompassing the most advanced designs available anywhere in the world.
Below is a selection of different Bifocal lens implants that I regularly call upon in both my customised cataract surgery and in refractive lens exchange procedures.
Multifocal / Bifocal Lens implants
Acrilisa Bifocal: http://zeiss.acritec.eu/Bifocal-Optic.47.0.html?&L=1
This is an excellent bifocal lens implant. I find this implant useful when attempting to create good near vision without reading glasses in people who have quite demanding near vision tasks, I have found it to be especially useful in people with unusually small pupils where some multifocal lens implants may disappoint.
Physical Properties : Hydrophilic Acrylic, Optic Size 6.0mm, Total size 11.0mm, Aspheric Optics, cartridge injectable, near add +3.75.
Summary : Good for demanding near vision and In cases of small pupils
Acrilisa TORIC Bifocal: http://zeiss.acritec.eu/Bifocal-Optic.47.0.html?&L=1
This lens implant works in the same way as the Acrilisa Bifocal lens implant but the ‘TORIC” format allows for astigmatism control. Although most patients will have some degree of expected astigmatism after lens implant surgery - this can often be lessened or eliminated by the appropriate surgical techniques. However where the level of astigmatism is high this TORIC bifocal is a major breakthrough. I have used this lens implant to correct high levels of astigmatism simultaneously providing excellent bifocal vision.
Physical Properties : Hydrophilic Acrylic, Optic Size 6.0mm, Total size 11.0mm, Aspheric optics, cartridge injectable, Bitoric optics, near add +3.75.
Summary : An excellent lens for correcting high levels of astigmatism whilst simultaneously providing distance and close vision without glasses.
Lentis M Plus: http://www.topcon-medical.eu/pm_uk.html?pmProductId=175
This revolutionary new lens, looks a little more like a bifocal lens in that the near viewing portion of the lens is placed on the lower side of the implant. In magnified images of this lens it does have the look of bifocal spectacles. However the optical principle is a little more complex than that and this implant produces true bifocal vision without the patient having to “move” their eyes about - you look and its just there ! I implanted the very first Lentis M plus lens implant in Yorkshire in November 2009 (read case study - jane o callaghan and ascario pagliario). My experience with this implant has been highly positive with virtually all patients treated with this implant experiencing excellent distance and close vision without glasses. One added benefit of this bifocal implant is the somewhat lower incidence of nighttime glare and haloes around headlights as compared to some bifocal implants. Im also pleasantly surprised to see some patients gaining useful middle distance vision too. Middle distance refers to VDU work, mobile phone usage etc. It has recently become avialable in a lower power reading add of +1.50 which may be better suited to avid computer users who prefer to work at a further near working distance of around 60cm.
Physical Properties : Hydrosmart polymer Acrylic, Optic Size 6.0mm, Total size 12.0mm, Cartridge injectable, near add +3.00 & +1.50add
Summary : Good for demanding near vision and In cases of small pupils. Possibly fewer unwanted optical side effects that often affect other bifocal implants.
Restor Lens:
This bifocal implant is made from the long established Acrysof material. It comes in two close vision power strengths - a +4.00 add that is good for close vision reading type activities and a +3.00 add that is more efficient at providing good vision slightly further out - when arms are at mid stretch - this lower power add in fact is proving useful for all round general near vision work.
Physical Properties : Acrysof hydrophobic Acrylic, Optic Size 6.0mm, Total size 12.0mm, Cartridge injectable, near add +4.00 and +3.00.
Summary : Good lens for general close vision activities with some usefulness for VDU/ computer range near work.
The Refractive Package : Where needed, Inclusive Laser vision enhancement
Bifocal / multifocal lens implants are the most exacting types of lens implant. They work best with a "zero" requirement for distance glasses. This is achievable in the vast majority of patients undergoing this type of customised cataract surgery, in my practice. If however we find that there is a small optical requirement to help get vision to the highest standard I will normally recommend Laser vision enhancement to "fine-tune" the focusing power of the eye with either LASIK or LASEK. This is an absolutely integral part of the service in my practice. Patients opting for fully customised cataract surgery will be afforded this added service entirely without further charge. In general however, less than 10% of patients typically require laser vision enhancement in my practice.
If you are considering the benefits of fully customised cataract surgery and especially if you are considering the wonderful benefits of bifocal / multifocal lens implants - please ensure that;
- your surgeon and your centre can also provide this special aftercare service.
- You clarify whether any further charges would apply if you were to require Laser vision enhancement.
- If your surgeon does not provide the Laser corrective procedure - please ask who & where you will you be referred to in the event you do require this service. Again ask for clarification regarding any further charges that may be applicable.
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