Standard monofocal intraocular lenses can correct myopia (nearsightedness) or hyperopia (farsightedness) simultaneously with cataract surgery. In most cases, you will need glasses after surgery – mostly for reading and computer work. Modern special lenses, on the other hand, can also correct astigmatism and even presbyopia. This enables cataract surgeons to satisfy the increasing needs and demands of our patients to significantly improve their vision and become independent of their glasses. After all, a life without glasses or one of being almost eyeglass-independent means regaining a high level of quality of life.
After a detailed ophthalmic examination, I will discuss your personal needs with you in detail, the requirements and what you expect from cataract surgery.
The choice of the intraocular lens
The choice of the intraocular lens that is right for you depends entirely on your personal situation. All circumstances such as work, everyday habits, hobbies, lifestyle and your individual requirements regarding your vision, but also the design of your eye or concomitant eye diseases when considering which lens is best for you. Thus, I put special emphasis on our personal conversation during the preoperative examination in order to bring all these factors together and to be able to offer the solution that is best for you and your eye.
Wide Range of Different Premium Intraocular Lenses
We can rely on a wide range of different premium intraocular lenses. Thanks to my many years of experience in this field, I can guarantee that I only offer the products I achieved the best results with and am also scientifically convinced of. A combination of different intraocular lenses is often a good option. Premium solutions are always custom-made.
15 to 20% of cataract patients have corneal astigmatism of 1.5 diopters or more. This means that without correction (glasses, contact lenses) the image will be blurry in the distance as well as at near.
We have several options for correcting astigmatism:
Toric intraocular lenses
Toric intraocular lenses can correct astigmatism with a special optical zone (torus). During implantation, the lens must be precisely aligned along the calculated axis in order to ensure optimal correction of astigmatism. Sometimes the toric lens can rotate in the eye after surgery; in this case we can rotate the implant back to the original axis with a small operation.
Arcuate laser incisions (limbal relaxing incisions)
We can also use the femtosecond laser to perform high-precision arcuate cuts that can correct astigmatism.
With increasing age, the natural lens loses its elasticity, becomes more rigid and can no longer bend. This is the beginning of presbyopia. It means loss of near focus reaction (accommodation) – and thus the loss of near vision without glasses.
The correction of presbyopia
The correction of presbyopia, i.e. restoring the ability to see clearly both at distance and near without glasses, is one of our greatest challenges as cataract surgeons. With multifocal intraocular lenses or lenses with extended depth of field (EDOF lenses) we can offer you a solution for this problem. These lenses have several focal points, which makes it possible to see at different distances mostly without glasses.
- Bifocal intraocular lenses have two sharp areas of vision (focal points): at near (about 30 cm) and in the distance. In addition to the near and far range
- Trifocal intraocular lenses also have a range in the intermediate distance (around 70 cm) in which reading without glasses is possible. This intermediate distance is becoming more and more important due to the increase in new media such as laptops, tablets or smartphones.
- EDOF intraocular lenses (‘extended depth of focus lenses’) also can improve vision in exactly this area. Intraocular lenses that combine several technologies (trifocal EDOF lenses) also exist.
In order to reduce the side effects, other lenses have also recently come onto the market which are intended to increase the depth of field by modulating the optical wave front. There are various terms for this: EDOF monofocal IOLs, Premium monofocal IOLs, enhanced monofocal IOLs, monofocal Plus IOLs, Mono EDOF IOLs, IROF (increased range of vision) IOLs…
A combination of different lens models often offers an optimal solution.
Side effects of multifocal lenses
However, becoming -independent of glasses comes at a price; you have to accept side effects:
the special optical concept can reduce mesopic vision (contrast vision) and glare and halos around light sources can be perceived, especially in the dark. Therefore, these lenses are not suitable for professional drivers.
The decision which special lens is suitable for you (if any) will be made individually based on your personal needs.
No need for glasses
in the dark: halo of light around light sources, possibly reduced medopic (twilight) vision
Soon after surgery, the brain has to get used to the new visual impression, especially if you have multifocal lenses implanted. This phase is called neuroadaptation and often lasts three to six months, or even longer for some patients. In clinical studies, this adaptation phase to multifocal lenses taking several months could be clearly demonstrated with the help of magnetic resonance imaging (MRI) based on activity patterns in the brain.