IOL Options | Cataract Surgery Cornwall | Premium Vision SC

 

INTRA-OCULAR LENSES (IOLs)

Before intra-ocular lenses (IOLs) were developed, people had to wear very thick eyeglasses or special contact lenses to be able to see after cataract surgery. Now, with cataract lens replacement, several types of IOL implants are available to help people enjoy improved vision. Discuss these options with your eye doctor to determine the IOL that best suits your vision needs and lifestyle.

CATARACT LENS REPLACEMENT: HOW IOLs WORK?

Like your eye’s natural lens, an IOL focuses light that comes into your eye through the cornea and pupil onto the retina, the sensitive tissue at the back of the eye that relays images through the optic nerve to the brain. Most IOLs are made of a flexible, foldable material and are about one-third of the size of a dime.  Like the lenses of prescription eyeglasses, your IOL will contain the appropriate prescription to give you the best vision possible. Read below to learn about how IOL types correct specific vision problems.

Which lens option is right for you?

 

Before surgery your eyes are measured to determine your IOL prescription, and you and your eye doctor will compare options to decide which IOL type is best for you, depending in part on how you feel about wearing glasses for reading and near vision.The type of IOL implanted will affect how you see when not wearing eyeglasses. Glasses may still be needed by some people for some activities.If you have astigmatism, your Eye M.D. will discuss toric IOLs and related treatment options with you.In certain cases, cost may be a deciding factor for you if you have the option of selecting special premium lOLs that may reduce your need for glasses.

Monofocal lens

 

This common IOL type has been used for several decades. Monofocals are set to provide best corrected vision at near, intermediate or far distances. Most people who choose monofocals have their IOLs set for distance vision and use reading glasses for near activities. On the other hand, a person whose IOLs were set to correct near vision would need glasses to see distant objects clearly.Some who choose monofocals decide to have the IOL for one eye set for distance vision, and the other set for near vision, a strategy called “monovision.” The brain adapts and synthesizes the information from both eyes to provide vision at intermediate distances. Often this reduces the need for reading glasses. People who regularly use computers, PDAs or other digital devices may find this especially useful. Individuals considering monovision may be able to try this technique with contact lenses first to see how well they can adapt to monovision. Those who require crisp, detailed vision may decide monovision is not for them. People with appropriate vision prescriptions may find that monovision allows them see well at most distances with little or no need for eyeglasses. Presbyopia is a condition that affects everyone at some point after age 40, when the eye’s lens becomes less flexible and makes near vision more difficult, especially in low light. Since presbyopia makes it difficult to see near objects clearly, even people without cataracts need reading glasses or an equivalent form of vision correction.

 

 Simulation of vision throughout life and with correction of cataract with different types of lens implants

 

Multifocal or accommodative lenses

These newer IOL types reduce or eliminate the need for glasses or contact lenses. In the multifocal type, a series of focal zones or rings is designed into the IOL. Depending on where incoming light focuses through the zones, the person may be able to see both near and distant objects clearly. The design of the accommodative lens allows certain eye muscles to move the IOL forward and backward, changing the focus much as it would with a natural lens, allowing near and distance vision. The ability to read and perform other tasks without glasses varies from person to person but is generally best when multifocal or accommodative IOLs are placed in both eyes. It usually takes 6 to 12 weeks after surgery on the second eye for the brain to adapt and vision improvement to be complete with either of these IOL types.

 

Considerations with multifocal or accommodative IOLs

 

For many people, these IOL types reduce but do not eliminate the need for glasses or contact lenses. For example, a person can read without glasses, but the words appear less clear than with glasses. Each person’s success with these IOLs may depend on the size of his/her pupils and other eye health factors. People with astigmatism can ask their eye doctor about toric IOLs and related treatments. Side effects such as glare or halos around lights, or decreased sharpness of vision (contrast sensitivity) may occur, especially at night or in dim light. Most people adapt to and are not bothered by these effects, but those who frequently drive at night or need to focus on close-up work may be more satisfied with monofocal IOLs.

Halos/Glare

 

 

 Simulation of vision with Astigmatism  with correction of cataract with different types of lens implants

TECNIS® IOL

The latest addition to the TECNIS® Family of IOLs offers new optical technology for providing an Extended Range of Vision.

Traditional IOL solutions for treating presbyopia include Multifocals and Trifocals, which work on the principle of simultaneous vision by splitting light into multiple distinct foci, and Accommodative IOLs, which change in shape and power when the ciliary muscle contracts.

Traditionally with these technologies, the correction of presbyopia is commonly thought of in terms of the distinct distance for which functional vision is provided.

Key Needs for Presbyopia-Correcting IOLs

  • High patient satisfaction by providing reliable outcomes
  • Low number of complaints (on refractive outcomes or halos and glare)
  • No significant additional chair time

 

 

Introducing TECNIS® IOL, the first and only presbyopia-correcting extended range of vision IOL.

The TECNIS® Extended Range of Vision IOL delivers a continuous, full range of high-quality vision with incidence of halos and glare comparable to a monofocal IOL.1, 2

TECNIS® Extended Range of Vision IOL is available in both a Non-Toric version and a Toric version for patients with astigmatism.

 

Mechanism of Action

TECNIS® IOL merges two complementary enabling technologies

  1. The proprietary diffractive echelette design feature extends the range of vision.1
  2. The proprietary achromatic technology corrects chromatic aberration for enhanced contrast sensitivity.2

Proprietary Diffractive Echelette Design Feature Extends The Range Of Vision

Proprietary diffractive echelette design feature introduces a novel pattern of light diffraction that elongates the focus of the eye resulting in an extended range of vision.1

As evidenced by the measured light pattern when projected through the TECNIS® monofocal IOL, TECNIS® multifocal IOL and the TECNIS® Symfony extended range of vision IOL, there is one distinct focal point for distance with the TECNIS® monofocal lens, two distinct foci for the TECNIS® multifocal lens, and one elongated focal point for the TECNIS® Symfony extended range of vision IOL.


Elongated Focus Leads to the Continuous Range of High-Quality Vision1

The novel pattern of light diffraction projected through the TECNIS® Symfony IOL is shown below, along with the light patterns projected through the TECNIS® monofocal and TECNIS® multifocal IOLs for comparison.

The elongated focus of the TECNIS® Symfony lens leads to:

  • A continuous range of high-quality vision for far, intermediate, and near distances1
  • Halo and glare comparable to a monofocal (distinct single focus) IOL3
    • Multifocal IOLs work on the principle of simultaneous vision; one image is in focus while the out-of-focus image is suppressed; halos are caused by the out-of-focus image. Because the TECNIS® Symfony IOL has one elongated focus it has the halo and glare profile comparable to a monofocal IOL.3

 

TECNIS® Monofocal IOL
TECNIS® Multifocal IOL
TECNIS® Symfony IOL

Clinically Significant Increase In Range Of Vision

TECNIS® IOL Showed:3

  • 20/20 or better mean visual acuity from distance to 1.5 D of defocus
  • 20/40 or better mean visual acuity from distance to 2.5 D of defocus
  • 1.0 D increase in depth of focus throughout the defocus curve


Proprietary Achromatic Technology Corrects Chromatic Aberration2

Chromatic Aberration = 1.2 D4 Chromatic Aberration = 0.14 D5
  • The refractive index of the eye varies with wavelength causing the power of the eye to be wavelength dependent. Colors that are out-of-focus cause blur and reductions in contrast vision. This is called chromatic aberration.
  • The average eye has approximately 2 D of chromatic aberration between 400 and 700nm and 0.8 D between 500 and 640nm.6
  • Chromatic aberration can be corrected with a diffractive IOL with achromatic technology.4

Proprietary Achromatic Technology Results In Contrast Enhancement

Achromat technology for the correction of longitudinal chromatic aberration (LCA) causes contrast enhancement.

Correction of corneal chromatic aberration results in a sharper focus of light. When combined with correction of spherical aberration, it increases retinal image quality, without negatively affecting depth of focus.5,7

LCA = 1.20 Diopters4 LCA = 0.14 Diopters5
Photopic pupil
Mesopic pupil

Proprietary Achromatic Technology Results In Contrast Enhancement

Modulation transfer function (MTF) calculated for mesopic pupil sizes in clinically-validated eye models.5

  • MTF is a measure of the amount of contrast transferred by the optics in a visual system.5
  • The higher the MTF value, the more contrast is transferred to the image resulting in higher contrast sensitivity.5


CONTRAST PERFORMANCE OF TECNIS® EQUIVALENT TO TECNIS® 1PC MONOFOCAL IOL

White light MTF at 50 c/mm measured in the ACE model eye for a 5 mm pupil.8

 

New Zealand Clinical Study Confirmed Benefits of TECNIS® IOL

Objective

  • To confirm clinical benefits of TECNIS® Extended Range of Vision IOL when implanted bilaterally

Design

  • Open-label, multicenter study with up to three months follow-up

Treatments

  • 31 subjects bilaterally implanted with TECNIS® IOL and 10 subjects bilaterally implanted with TECNIS® Monofocal 1-Piece ZCB00 IOL

Endpoints

  • Defocus testing
  • Visual acuity
  • Dysphotopsia
  • Spectacle independence
  • Patient satisfaction

Status

  • All 3-month visits completed

Clinically Significant Increase in Range of Vision

TECNIS® IOL Showed:1

  • 20/20 or better mean visual acuity from distance to 1.5 D of defocus
  • 20/40 or better mean visual acuity from distance to 2.5 D of defocus
  • 1.0 D increase in depth of focus throughout the defocus curve


Near and Intermediate Visual Acuity Improvement Over Monofocal IOL

TECNIS® IOL Showed:1

  • 20/20 or better mean distance and intermediate visual acuity
  • A 2-line improvement in mean intermediate and near visual acuity


Better Functional Vision Than a Monofocal IOL

TECNIS® IOL patients experienced decreased limitations in performing near and intermediate tasks vs. monofocal.1


High Spectacle Independence with Halos Comparable to a monofocal IOL

High Spectacle Independence1

  • At three months, almost all TECNIS® IOL subjects experienced high spectacle independence at far, intermediate, and near distances.

 

Halos Comparable to a Monofocal IOL1

  • TECNIS® subjects reported no significant difference in glare or halo occurrence compared to a monofocal IOL.
  • There were no spontaneous reports of glare or halo at 3-month postop follow-up visit.


High Patient Satisfaction

97% of the 31 subjects implanted with the TECNIS® IOL indicated that they would elect to have the lens implanted again.1


New Zealand Study Micro-monovision Evaluation

Objective

  • To evaluate the effects of micro-monovision on visual performance with the TECNIS® IOL

Design

  • Open-label, multicenter study with at least six months follow-up

Treatments

  • Up to 31 subjects bilaterally implanted with TECNIS® IOL

Methods

  • Binocular visual acuities were measured at far, intermediate, and near through a series of simulated micro-monovision correction (+0.50, +0.75 or +1.00D unilaterally added over the manifest refraction)

Status

  • 26 subjects have completed 6-12 month postoperative follow-up

Binocular Visual Acuities


Binocular Visual Acuities


Binocular Visual Acuities


Binocular Visual Acuities

 

 

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