Lens Implant Multifocal Center
Our natural lens inside the eye has the ability to flex and focus at different distances, but unfortunately this flexibility begins to fade away around age 42. “Dysfunctional Lens Syndrome” describes this loss of focus due to the hardening of the natural lens. This forces patients to wear reading glasses for near tasks such as reading, viewing the cell phone, and working on the computer. This can be very frustrating, but fortunately technology has evolved to keep up with our everyday needs. With today’s advanced lens procedures, patients can have a multifocal lens or extended depth of field (EDOF) lens to reduce their dependence on glasses. These intraocular lenses (IOL) can be implanted at the time of cataract surgery. They can also be implanted before a cataract develops fully; this procedure is called a Refractive Lens Exchange (RLE).
A multifocal lens is designed to provide clear vision in the distance and near. Multifocal lenses include the PanOptix Trifocal (Alcon), Tecnis Multifocal (J&J), and ReSTOR Multifocal (Alcon). Multifocal lenses have been used extensively over the past ten years. These lenses provide freedom from glasses for over 90% of patients who have them in both eyes. The lenses have multiple rings of focus and provide an increased range of vision compared with monofocal lenses, although it is common to see halos at nighttime around bright light sources like headlights. Patients often notice halos but these improve over time through a process called neuroadaptation as the brain learns to ignore the halos. This continues to improve over the first 6 to 12 months after surgery.
PanOptix Trifocal IOL
Our surgeons are comfortable implanting all the available multifocal lenses but have increasingly been using the newest multifocal, the PanOptix Trifocal IOL. This lens provides better intermediate vision than other multifocal lenses without compromising the distance and near vision. The previous generation of multifocals provided the sharpest vision at two focal points, distance and near. Many patients who had these lenses still needed to use computer glasses. The PanOptix Trifocal IOL offers an additional third focal point to provide sharp vision at intermediate range, in addition to the distance and near. Many of us need sharper intermediate vision not only for computer and tablet use but also for other activities like grocery shopping. We expect our patients that have this lens to see clearly in the distance, intermediate, and near.
Symfony Extended Depth of Field (EDOF) IOL
The Symfony EDOF IOL is a lens designed to provide functional high-quality vision from far distance to about 26 inches to minimize the use of glasses. This lens is designed to provide clear vision for driving as well as the use of the computer and tablets. There are some night time artifacts that decrease over time through the process of neuroadaption. This lens is better for patients who want sharp distance and computer vision and do not mind using reading glasses for near work. Also, patients who are not candidates for a multifocal lens may still be a candidate for the Symfony IOL.
Are there other lenses that can improve near vision?
Monofocal lenses can be adjusted to provide monovision where the dominant eye is set for the distance and the other eye is set for near. Many patients already use monovision with contact lenses. If they have already adjusted to monovision, cataract surgery or refractive lens exchange can be performed to duplicate the same monovision they enjoy with contact lenses. There can be some loss of depth perception with monovision, so it may not be a good option for everyone. We always encourage patients to try monovision first with contact lenses before having monovision surgery to make sure it is the best choice for them.
Will I need the procedure again? How long does it last?
The intraocular lens is designed to last a lifetime and the lens should not become cloudy or change position. The lens typically does not need to be replaced except in only very rare circumstances. In addition, the eye does not typically change in refraction significantly after an intraocular lens has been placed. The main reason for a refraction change is a worsening cataract (the clouding of our natural lens), which is removed with a refractive lens procedure. Some patients may develop a clouding or film behind the lens implant, which typically can be cleared with an in-office YAG laser procedure. This should return the vision to how it was immediately following the lens implant procedure.
Is Refractive Lens Exchange Painful?
The procedure is done as an outpatient at our surgery center with topical anesthesia (eye drops). There should be no eye pain during the surgery and the procedure itself lasts 15 minutes. There are no sutures placed and the eye does not need to be patched. Recovery is quick and most patients resume their normal activities within 1-2 days following the procedure.
How do I pick the right surgeon?
It is important to realize the Refractive Lens Exchange is not typically performed by a surgeon who specializes in only LASIK and in fact, it may not be mentioned during a consultation with a LASIK specialist. After age 50 it is very common to have the beginnings of a cataract and therefore Refractive lens Exchange often provides clearer and more long-lasting vision than LASIK, especially for far sighted individuals. Drs. Beers and Liu have extensive experience with LASIK as well as with lens implant procedures. In fact, they have taught the residents at Stanford University the latest techniques in lens implant procedures. We also perform all of our own post-operative care to make sure your recovery goes as smooth as possible.
How can I find out if I am a candidate for Refractive Lens Exchange?
Many patients over age 45 have complaints of their vision “not being as clear as it used to be” with some glare and halos at night. These are the symptoms of an early cataract that can be improved with Refractive Lens Exchange. If you are having some of these symptoms, you may be a good candidate for Refractive Lens Exchange. We encourage patients to come in for a complimentary consultation that includes corneal mapping and a retinal scan to help determine if you are a good candidate for Refractive Lens Exchange. Drs. Liu and Beers will discuss your lens options that would best match your lifestyle.