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INTRAOCULAR LENSES

Intraocular Lenses (IOL)

Intraocular Lenses (IOL)

What are Intraocular Lenses?

Various permanent intraocular lenses (IOLs) are used in cataract surgery or in refractive transparent lens surgery, which is also described as a procedure to eliminate the need for glasses.

When the eye's lens is removed due to cataract or for refractive purposes, approximately 30% of the eye's focusing power is lost.

To restore this power, a permanent lens is implanted inside the eye. These lenses can be classified based on their optical properties, materials, and shapes. Additionally, where they are manufactured and whether they are approved for use in countries like the USA and European Union is also crucial.

Prof. Dr. Ahmet Akman has been using IOLs manufactured in the USA and Germany, approved by the FDA, in cataract surgeries he has performed in Ankara for 20 years. IOLs produced in our country are also of high quality. However, there are very cheap lenses produced in the Far East, especially in India, where the material quality and sterilization are not reliable. Such lenses can cause problems in the eyes they are implanted in the early period and may deteriorate after a few years, causing vision loss.

Classification of Intraocular Lenses Based on Optical Properties

Intraocular lenses can primarily be divided into two categories based on whether the patient has astigmatism: standard and astigmatism-correcting toric intraocular lenses.

They can also be classified as single-focus or trifocal (multifocal) smart lenses.

  1. Standard (Single-Focus) Lenses
  2. Standard Single-Focus Toric (Astigmatism-Correcting) Lenses
  3. Smart Trifocal Lenses
  4. Smart Trifocal Toric (Astigmatism-Correcting) Lenses
  5. Smart EDOF (Extended Depth of Focus) Lenses
  6. Smart EDOF Toric (Astigmatism-Correcting) Lenses

1. Standard (Single-Focus) Lenses

Standard (single-focus) lenses have been the most commonly used lenses for the longest time. They are single-focused and do not have astigmatism-correcting properties. When set for distance vision, they show distance clearly without glasses or with low-powered glasses. However, they do not have near focus, so patients still need glasses for reading.

In higher-quality lenses, there are UV filters, blue light filters, and they are aspheric. Their advantages include very high-quality distance vision and no issues like nighttime light scattering. Cost-wise, they are the most affordable lenses.

For patients with retina problems, macular degeneration, advanced glaucoma, and issues with lens-supporting structures, these lenses are essential. For patients where these lenses are preferred to reduce the need for near glasses, one eye can be slightly myopic.

This method, known as monovision, allows one eye to see far and the other to see near without glasses. With the introduction of smart trifocal lenses, this method has largely been abandoned.

Prof. Dr. Ahmet Akman generally prefers trifocal lenses approved by the American FDA and the European Union CE for cataract surgeries involving this type of lens in Ankara. The hydrophobic aspheric lens has been implanted in over 30 million eyes worldwide and is a reliable, high-performance lens.

2. Standard Single-Focus Toric (Astigmatism-Correcting) Lenses

These are single-focus lenses with the properties described above. However, if the patient has astigmatism, they also correct it. In fact, about 30% of cataract patients have astigmatism and need these lenses.

Due to the additional measurements, calculations, expertise required, and slightly higher costs, these lenses are not used in most centers, including public hospitals. As a result, patients with uncorrected astigmatism spend the rest of their lives dependent on astigmatic glasses, which often cost much more than the lens itself.

Prof. Dr. Ahmet Akman is one of the leading experts in our country on toric astigmatism lenses. He generally prefers trifocal toric lenses approved by the American FDA and the European Union CE for this purpose.

The calculation of standard single-focus toric lenses is performed by the company's website, and a lens suitable for the patient is found. During the surgery, this lens is placed at the calculated angle to correct the astigmatism.

When choosing a center for cataract surgery, always ask about your astigmatism level and whether toric lenses are used. Prof. Dr. Ahmet Akman's article on this subject, "Sometimes Cheap is Expensive," has recently been published.

Video: Prof. Dr. Ahmet AkmanIntraocular Lenses (IOL) TypesAll Videos

3. Smart Trifocal Lenses

Smart trifocal lenses behave like three lenses nested inside each other. The first focuses on distance, the second on computer distance, and the third on reading distance.

The term "smart lens" actually emerged not as a medical term but as a marketing technique. These lenses have been available for 20 years, but their models produced in the last 2-3 years have approached the ideal, and their popularity has increased.

Especially in daily life, being able to read a ringing phone, see product labels in a supermarket, read books or newspapers without glasses brings great comfort. For patients suitable for these lenses, they are an excellent option. However, due to their structure, they can cause a few light halos around point light sources (street lamps, car headlights on a long road) at night.

Individuals who understand the importance of near vision without glasses usually do not mind this issue, but this information is always given to patients beforehand.

Smart trifocal lenses, like multifocal glasses, are more expensive than regular lenses. Achieving good results depends on factors such as preoperative appropriate eye selection, understanding the patient's expectations, very precise lens measurement with optical biometry devices, and perfect surgical placement.

Prof. Dr. Ahmet Akman has many years of experience in trifocal lenses. He regularly educates Turkish and foreign eye doctors through research articles published in international journals, presentations at conferences in the USA and Europe, and training programs. Prof. Dr. Ahmet Akman generally prefers trifocal lenses approved by the American FDA and the European Union CE for smart trifocal lens applications in cataract patients.

4. Smart Trifocal Toric (Astigmatism-Correcting) Lenses

Smart trifocal toric lenses are the most advanced lenses in production. They provide clear vision without glasses for near and intermediate distances and correct distant astigmatism, eliminating the need for distance glasses.

If patients who decide on smart lens application also have astigmatism, excellent results can be achieved with these lenses. Their calculations are quite complex. Prof. Dr. Ahmet Akman is one of the most experienced eye surgeons in our country on astigmatic toric smart lenses. He generally prefers trifocal toric lenses approved by the American FDA and the European Union CE for patients with astigmatism who want smart lens applications.

5. Smart EDOF (Extended Depth of Focus) Lenses

Smart EDOF lenses are the most advanced lenses in production. Due to their ringless structure, they provide clear vision for distance and intermediate distances without glasses and do not cause the most significant problem of trifocal lenses, which is nighttime light flares. Except for fine print, patients can see distances of 40-50 cm, like computers and phones, without glasses in their daily lives. While their fine print performance is not as good as trifocal lenses, their night vision quality is much better than trifocal lenses.

6. Smart EDOF Toric (Astigmatism-Correcting) Lenses

Smart EDOF toric lenses correct astigmatism like their counterparts. Their other features are the same as smart EDOF lenses.

Update Date: 23.04.2021
Ahmet Akman M.D.
Editor
Prof. Dr. Ahmet Akman
Göz Hastalıkları Uzmanı, Katarakt, Glokom ve Ön Segment Cerrahisi
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