Cataract surgery
The world's first intraocular lens application was successfully implemented in 1949, after a British fighter pilot's eye was injured, and entered our routine lives. In today's world, in parallel with technological developments in almost every field, important innovations are also occurring in intraocular lens technology. Multifocal/trifocal intraocular lenses, which are popular today and have 2 or 3 focal features, are widely used. Characteristics of cataract patients such as age, reading habits, professional positions, social activities and intellectual levels play an important role in patient selection.
Multifocal and Toric Intraocular Lenses (Smart Lenses)
In recent years, intraocular lenses (IOLs) produced with special technological methods have been used in cataract surgery. These lenses, also called premium lenses, provide distance, intermediate and near vision without glasses.
As a result of dizzying developments in lens technology, many lenses have been developed, from monofocal lenses to toric multifocal lenses.
Monofocal intraocular lenses are single-focus and allow patients to see better only in the distance. Since these lenses cannot correct astigmatism, they may sometimes need to wear glasses for distance after surgery. In addition, they have to use glasses because they cannot see well at near distance.
Multifocal intraocular lenses are bifocal lenses produced with different technologies and allow patients to see both near and far without glasses after surgery. An undesirable feature of multifocal intraocular lenses is that they intermediate vision may not be satisfactory.
In recent years, technological developments have led to 3-focus trifocal intraocular lenses, which allow patients to see better in the middle distance. Trifocal intraocular lenses have three focuses and show better distance, near and middle distance between approximately 50cm and 2m. It provides extremely good visual rehabilitation if fitted to suitable patients.
Multifocal-Trifocal Toric intraocular lenses are lenses that are implanted to people with high astigmatism and correct astigmatic vision defects as well as distance, near and intermediate distance.
To whom are these lenses applied?
Smart lenses are special intraocular lenses produced with advanced technology that can provide our far, intermediate and near distance vision without glasses. These lenses are implanted to patients for two main indications:
Group 1 is the patients who are planned for surgery due to cataract. These patients want to maintain their distance and near vision without glasses after the surgery. Smart intraocular lenses can be applied very successfully depending on the eye condition of these patients.
2.hasta grubunda ise belirgin katarakt yoktur ama özellikle yüksek hipermetropi, miyop veya astigmat vardır. Uzak ve yakın görüşte gözlüğe bağımlı olmak zorundadır. Bu tip hastalara uzak ve yakın sorununu gidermek için çoğu zaman LASİK gibi kornea üzerine yapılan refraktif cerrahi girişimleri yetersiz kalır ayrıca LASİK işlemi yakın görüş sorununu (presbiyopi) yeterli şekilde çözememektedir. Bu tip hastalarda katarakt olmasa bile trifokal göz içi lensleri hastalara gözlükten bağımsız uzak ve yakın görüş imkanı verilir.
How are trifocal Intraocular Lenses applied?
Whether the patient has a cataract in the lens or a clear lens replacement, the placement of these lenses in the eye is done through cataract surgery using the phaco method. After detailed information is given to the patient before the surgery, the anterior and posterior segments of the eye should be examined and detailed and sensitive tests should be performed. Sometimes, even if no abnormal findings are detected, in some cases due to the structure of the eye, smart lenses may not be implanted. In this case, so-called semi-smart lenses can be worn. The lens number is determined as a result of precise and repeated measurements. During the surgery, the eye is anesthetized with drops and the surgical procedure takes approximately 10 minutes. A small incision is made in the patient's eye, and after the clear lens or cataract is removed, the appropriate trifocal lens is placed into the eye. One hour after the procedure, the patient is sent home and the next day after the surgery, the patient can open his eyes and return to his normal life.
Things to consider for successful results!
In terms of patient satisfaction, meeting the appropriate patient with the appropriate lens is the main factor of success. It is necessary to thoroughly evaluate patient expectations before surgery and act accordingly. Trifocal or Toric intraocular lenses may not be suitable for every patient. The surgeon can decide this by evaluating the patient's eyes with sensitive measuring devices before surgery. Implanted a premium intraocular lens to an unsuitable patient group may require difficult surgical interventions that may lead to lens replacement in the future.
Which Patients Should Not Have Trifocal Intraocular Lenses?
Those with severe dry eyes
Macular degeneration (those with macular degeneration)
For those who have retina problems due to diabetes
For those with retina and macular disease
Glaucoma (especially in advanced cases)
Uveitis patients
What are the side effects of smart lenses?
After the trifocal lens is placed, the patient must retrain his or her own eye to focus at distance, intermediate distance, and near. This adaptation process can take up to 6 weeks. Especially pilots, drivers who drive at night, and people who spend most of their time in front of the computer are not suitable for multifocal lenses. People who are extremely sensitive to light may have problems with this type of lenses. Moreover
Difficulty distinguishing colors in low-light environments
Seeing halos, rings, and light scattering around lights
Infection
Increased floaters or retinal detachment
Defocus and decreased vision as a result of lens shift
Wrinkles and cloudiness may appear in the capsule behind the intraocular lens
Additional surgery may be required to reset the glasses prescription.
In conclusion
Both trifocal and toric intraocular lenses offer highly effective options for correcting this high astigmatism. For this purpose, good patient selection, the experience and knowledge of the surgeon, as well as the quality of the materials used are extremely important to achieve a successful result.