Replacement of the eye lens

Presbyopia, or simpler, near vision disturbance, is a common problem for patients after the age of 45, and sometimes even earlier.

This issue can be solved today with the implantation of multifocal intraocular lenses, or even with the extended depth of focus (EDOF).

Almost all patients older than 45 years who want to get rid of their reading glasses are good candidates for this surgery. There is no upper age limit, but it is important that the macula (back of the eye) is healthy and preserved to get the full effect of these lenses.

Before the surgery, a detailed examination of the anterior and posterior segments of the eye is performed, and a calculation of the intraocular lens power is made. The patient is presented with the results and based on a detailed conversation with the surgeon, the best option is chosen. We emphasize that preoperative patient/surgeon consultation is of the utmost importance. A patient’s everyday activities, habits and expectations are thoroughly discussed, so there is no misunderstanding about potential postoperative limitations.

The surgical procedure lasts only 10 minutes per eye. Sometimes we do one eye first and the other one in the next few days, but oftentimes both eyes are operated on the same day. In almost all patients the topical anaesthesia (anaesthesia with the eyedrops) is sufficient. During the procedure, the natural eye lens is removed, and an EDOF/trifocal lens is implanted in its place.

The incisions heal by themselves, so there is no need to suture the wound.

Advantages of Lens Replacement Surgery:

Lens replacement surgery can significantly reduce the need for glasses, offering clearer vision at all distances. It’s a permanent solution for age-related vision problems like presbyopia and cataracts, improving your quality of life. Recovery is usually quick, and the new lens lasts a lifetime.

Disadvantages:

Adjusting to the new vision may take time, and there’s a small risk of complications like glare or halos. The procedure may also be more expensive than traditional cataract surgery.

Lens replacement surgery, while generally safe, carries some risks. These include potential infections, increased eye pressure, or retinal detachment. Some patients may experience glare, halos, or difficulty adjusting to their new vision. Rarely, there may be complications that require additional surgery. However, these risks are minimal when performed by an experienced surgeon, and the vast majority of patients experience successful outcomes with improved vision.

When it comes to presbyopia, there are two types of intraocular lenses that can solve this refractive error.

The first ones are diffractive trifocal intraocular lenses. The optic of these lenses is designed with more than one focal zone, which means that depending on the pupil size the person can see far, intermediate, and near without glasses, and all depending on the focal zone they are looking through.

On the other hand, the EDOF lenses are the latest technological achievement when it comes to correcting vision over all distances. This technology is more reliant on the natural pupil size and has only two indistinct focal zones. With these lenses, patients can have excellent far and intermediate vision, and very good near vision.

Some patients must wear reading glasses even after the implantation of these lenses, but usually only for the smallest print. However, their advantage is lack of photic phenomena, also known as halos and glare.

This phenomenon is seen in all diffractive trifocal intraocular lenses and consists of starbursts that patients see during the night and slight decrease in contrast sensitivity.

The second group consists of the so-called diffractive multifocal intraocular lenses, known for more than 15 years.

Although today’s technology is much more advanced than previous generations, they still have similar or the same side effects. They are reflected in a greater or lesser degree of scattering of light at night and a slight decrease in color contrast.

Nevertheless, with these implants, patients see excellently at distance and medium distance, as well as with EDOF lenses, and the independence from near glasses is over 95%

Lens replacement surgery involves several steps.

1. First, numbing drops are applied to the eye
2. A small incision is then made in the cornea, through which the cloudy natural lens is removed
3. An artificial intraocular lens (IOL) is inserted into the same position
4. The procedure is quick, usually under 30 minutes, and no stitches are required.

After the surgery, patients may be prescribed eye drops to prevent infection and reduce swelling during recovery.

The recovery lasts several days, usually five to six. During this time, the patient is advised to avoid smoke, wind, and dust, as well as lifting heavy weights. Antibiotic/corticosteroid eyedrops are also used during this time.

These lenses are permanent, they do not need to be exchanged, nor can they become cloudy like our natural eye lenses, which means that cataract cannot develop on them.