Text author: Dr sc. Bojan Kozomara, M.D.
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.
This group includes the Alcon Vivity EDOF intraocular lens, which our Dr. Bojan Kozomara chose for his eyes.
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%. Alcon Panoptix intraocular lens belongs to this category.
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 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.
In addition to prior consultation and discussion with the doctor, it is possible to perform surgical procedures on both eyes on the same day. This accelerates the merging of images from both eyes in the visual center of the brain, shortening the adjustment time and avoiding undesirable effects, particularly the difference in visual acuity between the two eyes between surgeries.
Perhaps most importantly, it should be emphasized that these lenses are permanent, do not need to be replaced, and cannot become cloudy like our natural eye lenses, meaning that cataracts (clouding of the lens) cannot develop on them.
