Modern artificial intraocular lenses (IOLs)

There is no definite answer to the question of which artificial lens is objectively the best. Ophthalmologists say: “Intraocular lenses are as unique and different as our patients.” This means that the selection of artificial lenses is treated very individually, and those that will delight one patient will be completely useless for another.

When preparing for artificial lens implantation surgery, it is worth asking yourself m. in. The following questions:

• Do I still want to wear glasses after surgery?

And if so, whether:

• Do I prefer to see better from a distance or up close?
• Do I want sharp vision at all distances – near, intermediate and far?
• Do I care about simultaneous cataract surgery,presbyopia and vision correction?
• Do I want to further protect the retina with a blue light filter?

Most often, replacement of the native lens with an artificial one occurs in patients of advanced age. The reason for the replacement is most often cataract or presbyopia. Sometimes both problems occur simultaneously.

In the case of cataracts, replacement of the patient’s own lens with an artificial lens is essential, as the own lens becomes cloudy, which can even lead to complete loss of vision. In cases of presbyopia, the patient’s own lens becomes progressively stiff, which, with the concomitant weakening of the eye’s accommodative ability, results in a significant loss of visual acuity.

As if that weren’t enough, both people struggling with cataracts and presbyopia may be additionally burdened with vision defects: nearsightedness, farsightedness or astigmatism.

What is an artificial lens?

A modern intraocular lens (from the English intraocular lens, IOL) is a plastic lens characterized, depending on the type, by different properties of focusing and scattering light. The lenses in use today are usually high-quality lenses built with a round main part and two arms (hapten), whose role is to hold the lens in the correct position. So-called retractable lenses can be inserted into the eye through a small, 2mm hole made during cataract surgery.

It’s worth knowing that both cataract surgery and presbyopia correction can use a lens replacement that will eliminate not only the original problem, but also correct the visual defect.

Lens replacement can be done with a variety of customized lenses.

Cataracts and presbyopia are used in the treatment of cataracts:

• monofocal lenses (also known as “enhancement lenses” ) spherical and aspheric – depending on the option chosen, the patient may experience less (aspheric lens) or more (spherical lens) image distortion at the periphery of the lens.
• multifocal lenses (trifocal/multifocal or EDOF – extended depth of focus), thanks to which, in addition to cataract removal, the patient can count on very good visual acuity for distance, near (35-40 cm) and intermediate distance (60-90 cm)
• single vision toric lenses (eliminate astigmatism, provide sharp vision for either distance or near) or multifocal toric lenses (eliminate astigmatism, provide sharp vision for distance, near and intermediate distances)

Standard monofocal lenses ensure that we can only see clearly at one distance. They are the only ones reimbursed by the National Health Service.

What are the functions of UV filter and blue light filter?

Modern artificial lenses of white or yellow color can be additionally equipped with UV filters and/or blue light filter – blue light filter. Blue light and UV rays harm the retina, accelerating the development of any degenerative changes (among other things, they contribute to the onset of AMD – macular degeneration). Our own intraocular lens filters blue-violet light well, and therefore it is worth choosing implants that perfectly mimic this physiological filter of ours. Lenses with a blue-light filter also allow for the best visual contrast.

What are multifocal – trifocal lenses?

The performance of multifocal lenses is very similar to progressive lenses used in spectacle vision correction. These are multifocal (multifocal) lenses with a unique design that takes advantage of our brain’s ability for so-called neuroadaptation (it takes an average of one to three months, and even longer in some patients). They provide excellent vision quality and natural contrast sensitivity in both nearsighted and farsighted patients, as well as those with astigmatism.

What is an accommodative lens?

An accommodative lens (still in development) is an ultra-modern product of advanced biomedical engineering that allows the natural mechanisms of eye accommodation to be replicated in a close-to-natural way. This means acute near vision (reading), intermediate vision (computer work, socializing, glancing at the dashboard of a car), and distance vision (driving, observing distant landscapes).

It is a lens that combines excellent visual acuity with the best possible contrast and realistic color perception. By correcting imaging errors that can be caused by artificial lenses (aberrations), it improves visual perception, especially at dusk or in difficult weather conditions.

Correction of severe ametropia with two lenses

Ametropia is a visual defect caused by an abnormal ratio between the focusing ability of the eye’s lens and the anatomical dimensions of the eye.

Two artificial lenses can be used to correct severe ametropia – the latter to enhance the effect of a previously implanted intraocular lens. This is useful if the main lens alone proves too weak to compensate for severe hyperopia (farsightedness), for example. The secondary lens is implanted four to six weeks after the primary lens. Combining an IOL with a supplementary lens may also be a suitable solution in other cases, since two lenses of lower power are generally less thick than a single lens of higher power.

The use of a supplementary lens is also recommended in cataract surgery in children, since refraction in children changes due to growth. The additional lens can be updated without replacing the intraocular lens in the bag.