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Lens Implant Options

Changing lens implants within the eye is potentially problematic, and so it is important to carefully consider the lens implant options prior to surgery.

Toric Lens 

Toric lens implants are used to correct or reduce astigmatism at the time of cataract or lens replacement surgeries, and hence increase degrees of independence from glasses. 

Monofocal

These are the most commonly used lens implant type.  They have one point of optimal focus so you could use this type of lens implant to see in the distance, but then you will need glasses to see up close.  Alternatively you could have a monofocal lens implant aiming for reading vision, and then use glasses to see in the distance.

Extended Depth of Focus

These lens implants aim to give more intermediate and potentially near vision without needing glasses.  There is an increased risk of glare and / or halos around bright lights with theses lenses though such side-effects are rarely a longterm problem.

Multifocal

These lenses split the light coming into the eye aiming so that you can see distance, intermediate and up close without glasses.  They are used to give the highest chance of distance and reading vision without glasses.  They have increased risks though of glare and halos around bright lights and some people can not drive at night because of such side-effects.  One of my patients has kindly written a description about his experience with a form of multifocal lens (Tecnis Synergy).

Multifocal Experience
Review of the Johnson & Johnson Synergy IOL lens - Cataract procedure by Dr Lee I had the lens implant undertaken in both eyes just over two years ago due to cataracts. Prior to this, my vision was -6 in both eyes with astigmatism and I was dependent on glasses the whole time. Like many before I googled the vast lens options available and tried to gauge the best for me and the pros and cons of each. I had already seen multiple positive reviews of the Synergy IOL lens and that is the one I was interested in. Luckily Johnson and Johnson was the brand recommended by Dr Lee. A fantastic website he recommended was www.beyondcataracts.uk. This is well worth reading and you absolutely must use the brilliant visual simulator. That will truly bring the experience to life of what each lens can do for you. Rational for selecting the lens I opted for the Synergy IOL following a number of discussions with Dr Lee. This was based primarily on the benefits of near, intermediate and distance vision. It was an excellent opportunity for me to reduce dependency on the glasses and I would ‘probably’ only require them for reading. The reduced use for just reading, was acceptable for the freedom it would bring from having to wear glasses. In addition, I was made aware by both Dr Lee and the simulator that with this particular lens you can expect to see halo’s at night. Lights at night, namely LED car headlights will have this effect. This is primarily due to the design of the IOL lens which has concentric circles to remediate the vision at all distances. The simulator demonstrates this well in the night scenario. This was not an issue for me as I very rarely go out in the evenings in my car. Post surgery result Firstly, don’t worry about the immediate effects when you start looking with the eye. It will be blurry and when I had this done late evening and was being driven home, every light had huge halo’s. That will subside within a few days, if not before. Once that does wear off and in my case by the next day, I could see my OLED TV in nothing short of exceptional crystal clear vision. The change was incredible, I was sitting well away from the TV and it was totally clear. I never got that level of clarity even with my best glasses. I also found that I could see intermediate range with very good vision. Reading was a bit more difficult, but after a few days even that was well beyond my expectations. I could also read most of the bottom line on the opticians eye sight test board. Needless to say, I was very pleased with the result. In short, I now hardly ever wear glasses, not even for reading. In a week I may wear them for exceptional reasons of blurred news paper article or very small print as in terms and conditions. Overall, the result has far exceeded any expectations I ever had. The one thing I would call out is that whilst the halo’s have significantly improved, as expected the car headlights (mainly LED) do still cause halo’s. The tail lights are not as bad, nor are the older non LED headlights. It does mean I significantly reduce the amount of night time driving I do. I can still drive local and could go further, but don’t really have the need in the evenings. If you did need to drive, the only thing I would recommend is not to deliberately look at the headlights of the car’s on the opposite side. I think I was naturally drawn to them due to the halo’s but there is really no need. Just focus on the road in front of you. You need to weigh this important aspect with your lifestyle. If you are dependent on night time driving, then I would say this particular lens may not be suitable for you. For me it is a price I am very happy to pay. Just to clarify that at home, I don’t have any issues with lights at night. If I knew then what I know now, would I still pick the same lens? Yes, absolutely, totally, 101%. The difference this has made to me is life changing. I no longer wear glasses and I now have the brilliant vision that I had in my teens. I am now in my mid 50’s! Dr Lee was absolutely correct in his recommendation and the whole procedure undertaking the lens replacement was flawless. He was very patient and answered all my questions and concerns throughout. I have absolutely no hesitation in recommending Dr Lee, as a result of the fantastic work he has done for me and have recommended him to colleagues and friends. Needless to say, this is my experience of the lens. Dependent on your own factors, you may get different results. However, I hope this gives you a good idea of what this particular lens can offer you.

Alexa Young, CA

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