Dr. Suresh's Guide to Intraocular Lens (IOL)

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05 November 2022
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What are the 3 types of cataract lenses?

As part of cataract surgery, your natural lens will be removed and replaced with an artificial intraocular lens. There are three different types of intraocular lenses available including monofocal, toric, and presbyopic-correcting.

What type of IOL is best?

Multifocal IOLs

Multifocal and extended depth of focus IOLs offer the best chance to see both near and far without wearing glasses or contact lenses.

CHARACTERISTICS OF IOL:

1. FOLDABLE:

A foldable intraocular lens is literally folded to half its size. It makes an insertion of the IOL into the eye through a small incision possible. Incision may be as small as 1.8 mm. Once a foldable IOL is placed, it unfolds to its full regular size.

2. HYDROPHILIC IOL:

Hydrophilic lens attracts aqueous fluid which means that the colloids suspended in the aqueous fluid deposit faster on these lenses. It has been observed that hydrophilic IOLs are more susceptible to PCO or Posterior capsule opacification, i.e. the formation of an opaque layer on lens.

3. SQUARE EDGE IOL:

Commercially marketed square-edged IOLs differed in the sharpness of the posterior optic edge. Hydrophobic acrylic and silicone IOLs have sharper posterior optic square edge than most hydrophilic acrylic IOLs. This probably reflects difference in manufacturing techniques.

4. BICONVEX:

Most of our IOLs tend to be biconvex in design where the power of the lens is split between the anterior (front) and posterior (back) surfaces.

5. ASPHERIC OPTICS IOL:

Ultima Plus is Manufactured using our patented technology. It has biconvex aspheric opctics which provides better visual acuity and enhanced contrast. Ultima Plus has an innovative lens design that insures smooth insersion and proper positioning inside the eye and its 360° Square Edge reduces the incidence of PCO.

6. HYDROPHOBIC IOL:

One of these types are hydrophobic acrylic IOLs, which many consider to be one of the most popular types of IOL materials. Hydrophobic acrylic IOLs are generally foldable, have a rather low water content, and a high refractive index.

7. UV IOL:

Intraocular UV Protection Lenses

They protect your retina from possible photochemical deterioration. You lose this natural UV eye protection during cataract surgery. Through the implantation of innovative intraocular lenses (IOLs), UV eye protection returns.

8. THREE PIECES IOLS:

Single-piece IOLs have soft and broader haptics which are made of the same material as the optic, usually hydrophobic or hydrophilic acrylic, whereas 3-piece IOLs have rigid haptics which are made of poly methyl methacrylate (PMMA).

9. HYPERVISION:

The best vision we can achieve is 6/6 or even N6. Phaco surgery IOL can help you in getting 6/6 vision even if you have poor vision, but achieving the visual acuity of an eagle is next to impossible. While attaining eagle eyes will remain a fantasy for us, you can improve your eye sight through Phaco surgery IOL.

10. YELLOW IOL:

Yellow-tinted IOLs absorb blue light and are thought to protect the retina from damage, thus helping to prevent age-related macular degeneration after cataract surgery.

11. BLUE BLOCKING IOL:

Blue-light filtering IOLs have been suggested to impart retinal protection and potentially prevent the development and progression of age-related macular degeneration (AMD).

TYPES OF LENS:

Single Vision Lenses:

Single vision Distance.

Single Vision Lenses can be used for either Distance, Computer / Music or Reading vision. The lenses contain the same prescription throughout the lens and they are the most commonly used lenses in the optics Industry. They can be personalised with many different parameters. Please see below for further information.

Single vision glasses are designed to help people who require correction of farsightedness, nearsightedness, or astigmatism. These eyeglasses have just a single optical prescription correction and they distribute focus evenly over the entire surface area of the lens. Most people that wear glasses usually get this type. If you have multiple prescriptions you would require bifocal or multifocal eyeglasses.

Trifocal lenses:

Trifocal lenses are similar to bifocals, except that the two focal areas are separated by a third middle area with intermediate focus correction. This area is used for intermediate vision; roughly at arms’ length, e.g. computer distance. This lens type has two segment lines, dividing the three different correcting segments.

Multifocal lenses:

Multifocal Lens (a.k.a Progressive Lens) is the lenses with multiple prescriptions all in one lens. Multifocal lenses contain two or more lens powers to help you see objects at all distances after you lose the ability to naturally change the focus of your eyes due to age (presbyopia).

Toric Lens:

• In a normal healthy eye, the cornea is round and shaped like a basketball. Astigmatism occurs when the cornea is shaped more like a football.

• Light passes through the cornea with astigmatism, images do not focus sharply on the retina resulting in blurry vision.

• It helps to correct for astigmatism.

• A toric IOL helps compensate for the abnormal curvature of the cornea and corrects astigmatism whereas a standard IOL does not.

• Glasses are typically still needed for reading when a toric IOL has been implanted.

• provide excellent clarity in vision.

• quality of vision

• Useful for patients with astigmatism, keratoconus etc.

Toric Lens are a type of lens in which the focal length and the optical strength vary in two directions at 90 degrees from each other. One side appears like a torus cap, whereas the other side is usually spherical. It is used mainly in eye care, i.e. with an intraocular lens to fix astigmatism in contact lenses, and eyeglasses.

The results are more precise if these lenses are used after an astigmatic surgery. When it comes to the Toric lens vs the Standard lens, their function is very different, but their goal is the same.

Monofocal:

A monofocal IOL is an intraocular lens with a fixed focus for one distance. A cataract doctor may select monofocal IOLs that are for near focus, for mid-distance focus, or for distant focus. Only one of these three can be selected and the focus will not change after surgery.

• Restart vision for one distance.

• Require Glasses post surgery.

• No halos at bright light.

• Recovery Time Approx. 1 week

THE FOLLOWING ARE THE LENSES COMMONLY USED BY DR. SURESH

1. VIVITY IOL:

The new Vivity intraocular lens is the latest generation of lenses used to replace cataracts during cataract surgery. This lens is classified as “Extended Range of Vision.” This means patients will be able to see much better various at focal points.

2. TRIFOCAL IOL:

Trifocal IOL is the newer generation of multifocal lenses. It provides excellent functional vision not only near and far, but also at intermediate. The advanced aberration correction optic design of trifocal lens provides:

• Excellent vision at all distance - near, far and intermediate

• Excellent vision in all light-conditions

• No loss of contrast sensitivity.

• High rate of spectacle independence.

3. EYHANCE IOL:

The Eyhance lens is a specially designed monofocal lens. Instead of having a uniform lens, it's set to one refractive power on the lens's edges and then transitions to a different refractive power in the middle of the lens. The result is improved distance vision, both far away and at a middle distance.

4. TECHNIS IQ:

The TECNIS Monofocal 1-Piece IOL (model ZCB00) is made from a ultraviolet light-blocking hydrophobic material not associated with glistenings. According to data on file with the company, the lens has reduced chromatic aberration and spherical aberration is corrected to essentially zero.

5. ALCON IQ :

Made in USA, blue blocking, stable -yellow Lens, UV filter, photostress recovery fast, hypervision.

The AcrySof IQ IOL (Alcon) is designed to provide a youthful lens to patients with cataracts. With its advanced biocompatible material and innovative design, it is designed to mimic the young adult lens by not only reducing spherical aberrations, but also filtering blue light.

6. ACRIVISION IOL/ ALCON SINGLE PIECE:

Acrivision is an essentially glistening free lens that reduces the visual disturbances and minimizes the loss of light.

7. ACRIOL EC:

Acriol EC is a Yellow Hydrophobic Acrylic Intraocular Lens. It is manufactured by Synchronised Cast Molding procedure. Acriol has an innovative design that insures smooth insersion and proper positioning inside the eye and its square edges reduces the incidence of PCO.

8. ACRIOL:

Monofocal Indian foldable, hydrophobic square edge, aspheric.

9. RYCF:

RYCF design ensures smooth insertion and proper positioning inside the eye. Non Ionic Nature of Material ensures less incidence of PCO. Material is UV block incorporated ensuring adequate UV protection and has a 360° Square Edge

10. ACRYFOLD:

Hydrophilic Single Piece Foldable Intraocular Lens:

• Latest technology.

• Good memory and high accuracy.

• UV absorbable material.

• Incision can be made very much smaller.

• Prevents post- operative buckling of lens anteroposterior movement of the lens.

• Prevents post of Anteroproof movement of lens.

ADVANTAGE:

• Reduced lifetime cost of glasses and contacts.

• Multifocal IOLs can decrease your need for reading glasses or computer glasses after cataract surgery. These implanted lenses expand your range of vision, so you can see clearly at near and far without additional eyewear. Many patients who choose multifocal IOLs find they can be glasses-free or may only need reading glasses occasionally for reading small print following surgery.

• Multifocal IOLs improve near, intermediate, and far-distance vision, varying with the lens model chosen. In many cases, after having the lenses implanted, people no longer need to wear corrective lenses to see clearly.

• More freedom to live actively and unencumbered

• No upkeep or routine replacement necessary.

• The results of multifocal IOLs are long-lasting. Unlike contacts, multifocal IOLs are implanted inside the eye and don’t require any additional care or

routine replacement.

• See if the Multifocal IOL may be right for you

• Compare the following images. In the first image, which demonstrates vision with the Multifocal Lens, you can see the coffee cup close up, the dashboard at intermediate, as well as road signs in the distance—all clearly.

• Now, compare the second image. This image demonstrates what you might see with a monofocal lens. Although the intermediate and distance vision is clear, notice how the coffee cup is now blurry.

• Immediately after surgery, some patients may notice rings around lights when driving at night. However, as the eye adjusts to the lens, the visual impression of rings may lessen or go away over time.

• See if the Multifocal IOL may be right for you.