Multifocal intraocular lens

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Multifocal and accommodating intraocular lenses are artificial intraocular lenses (IOLs) that are designed to provide focus of both distance and near objects, in contrast to monofocal intraocular lenses which only have one focal point and correct distance vision. The issue of restoring accommodation following cataract surgery or through refractive lens exchange is becoming an increasingly important topic in ophthalmology.

Intraocular lenses that correct presbyopia are divided into two main categories: [1]

Evidence about different lenses

Monofocal lenses are standard lenses used in cataract surgery. People who have a multifocal intraocular lens after their cataract is removed may be less likely to need additional glasses compared with people who have standard monofocal lenses. [2] People receiving multifocal lenses may experience more visual problems, such as glare or haloes (rings around lights), than with monofocal lenses. [2]

People receiving accommodative intraocular lenses had improvements in near vision but these improvements were small and reduced over time. [3] People who received accommodative intraocular lenses may have a higher risk of thickening and clouding of the tissue behind the intraocular lenses (posterior capsule opacification) but there is some uncertainty around this finding. [3]

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<span class="mw-page-title-main">Far-sightedness</span> Eye condition in which light is focused behind instead of on the retina

Far-sightedness, also known as long-sightedness, hypermetropia, or hyperopia, is a condition of the eye where distant objects are seen clearly but near objects appear blurred. This blurred effect is due to incoming light being focused behind, instead of on, the retina wall due to insufficient accommodation by the lens. Minor hypermetropia in young patients is usually corrected by their accommodation, without any defects in vision. But, due to this accommodative effort for distant vision, people may complain of eye strain during prolonged reading. Some hypermetropes can see clear at distance, but near vision may be blurred due to insufficient accommodation. For this reason, this defect is referred as far-sightedness. If the hypermetropia is high, there will be defective vision for both distance and near. People may also experience accommodative dysfunction, binocular dysfunction, amblyopia, and strabismus. Newborns are almost invariably hypermetropic, but it gradually decreases as the newborn gets older.

<span class="mw-page-title-main">Presbyopia</span> Medical condition associated with aging of the eye

Presbyopia is physiological insufficiency of accommodation associated with the aging of the eye that results in progressively worsening ability to focus clearly on close objects. Also known as age-related farsightedness, it affects many adults over the age of 40. A common sign of presbyopia is difficulty reading small print which results in having to hold reading material farther away. Other symptoms associated can be headaches and eyestrain. Different people will have different degrees of problems. Other types of refractive errors may exist at the same time as presbyopia. This condition is similar to hypermetropia or far-sightedness which starts in childhood and exhibits similar symptoms of blur in the vision for close objects.

<span class="mw-page-title-main">Phacoemulsification</span> Type of cataract surgery

Phacoemulsification is a modern cataract surgery method in which the eye's internal lens is emulsified with an ultrasonic handpiece and aspirated from the eye. Aspirated fluids are replaced with irrigation of balanced salt solution to maintain the anterior chamber.

<span class="mw-page-title-main">Intraocular lens</span> Lens implanted in the eye to treat cataracts or myopia

An Intraocular lens (IOL) is a lens implanted in the eye as part of a treatment for cataracts or myopia. If the natural lens is left in the eye, the IOL is known as phakic, otherwise it is a pseudophakic, or false lens. Such a lens is typically implanted during cataract surgery, after the eye's cloudy natural lens (cataract) has been removed. The pseudophakic IOL provides the same light-focusing function as the natural crystalline lens. The phakic type of IOL is placed over the existing natural lens and is used in refractive surgery to change the eye's optical power as a treatment for myopia (nearsightedness). This is an alternative to LASIK.

<span class="mw-page-title-main">Phakic intraocular lens</span> Lens implanted in eye in addition to the natural lens

A phakic intraocular lens (PIOL) is a special kind of intraocular lens that is implanted surgically into the eye to correct myopia (nearsightedness). It is called "phakic" because the eye's natural lens is left untouched. Intraocular lenses that are implanted into eyes after the eye's natural lens has been removed during cataract surgery are known as pseudophakic.

<span class="mw-page-title-main">Eye examination</span> Series of tests assessing vision and pertaining to the eyes

An eye examination is a series of tests performed to assess vision and ability to focus on and discern objects. It also includes other tests and examinations pertaining to the eyes. Eye examinations are primarily performed by an optometrist, ophthalmologist, or an orthoptist. Health care professionals often recommend that all people should have periodic and thorough eye examinations as part of routine primary care, especially since many eye diseases are asymptomatic.

<span class="mw-page-title-main">Cataract surgery</span> Surgery to remove opacified lens from the eye

Cataract surgery, also called lens replacement surgery, is the removal of the natural lens of the eye that has developed an opacification, which is referred to as a cataract, and usually its replacement with an artificial intraocular lens.

<span class="mw-page-title-main">Astigmatism</span> Type of eye defect

Astigmatism is a type of refractive error due to rotational asymmetry in the eye's refractive power. This results in distorted or blurred vision at any distance. Other symptoms can include eyestrain, headaches, and trouble driving at night. Astigmatism often occurs at birth and can change or develop later in life. If it occurs in early life and is left untreated, it may result in amblyopia.

<span class="mw-page-title-main">Trabeculectomy</span> Surgical procedure used in the treatment of glaucoma

Trabeculectomy is a surgical procedure used in the treatment of glaucoma to relieve intraocular pressure by removing part of the eye's trabecular meshwork and adjacent structures. It is the most common glaucoma surgery performed and allows drainage of aqueous humor from within the eye to underneath the conjunctiva where it is absorbed. This outpatient procedure was most commonly performed under monitored anesthesia care using a retrobulbar block or peribulbar block or a combination of topical and subtenon anesthesia. Due to the higher risks associated with bulbar blocks, topical analgesia with mild sedation is becoming more common. Rarely general anesthesia will be used, in patients with an inability to cooperate during surgery.

<span class="mw-page-title-main">Endophthalmitis</span> Medical condition

Endophthalmitis is inflammation of the interior cavity of the eye, usually caused by infection. It is a possible complication of all intraocular surgeries, particularly cataract surgery, and can result in loss of vision or loss of the eye itself. Infection can be caused by bacteria or fungi, and is classified as exogenous, or endogenous. Other non-infectious causes include toxins, allergic reactions, and retained intraocular foreign bodies. Intravitreal injections are a rare cause, with an incidence rate usually less than .05%.

<span class="mw-page-title-main">Emmetropia</span> State of vision

Emmetropia is the state of vision in which a faraway object at infinity is in sharp focus with the ciliary muscle in a relaxed state. That condition of the normal eye is achieved when the refractive power of the cornea and eye lens and the axial length of the eye balance out, which focuses rays exactly on the retina, resulting in perfectly sharp distance vision. A human eye in a state of emmetropia requires no corrective lenses for distance; the vision scores well on a visual acuity test.

Vision of humans and other organisms depends on several organs such as the lens of the eye, and any vision correcting devices, which use optics to focus the image.

Laser blended vision is a sophisticated laser eye treatment which is used to treat presbyopia or other age-related eye conditions. It can be used to help people that simply need reading glasses, and also those who have started to need bifocal or varifocal spectacle correction due to ageing changes in the eye. It can be used for people who are also short-sighted (myopia) or long-sighted (hyperopia) and who also may have astigmatism.

<span class="mw-page-title-main">Capsulotomy</span>

Capsulotomy is a type of eye surgery in which an incision is made into the capsule of the crystalline lens of the eye. In modern cataract operations, the lens capsule is usually not removed. The most common forms of cataract surgery remove nearly all of the crystalline lens but do not remove the crystalline lens capsule. The crystalline lens capsule is retained and used to contain and position the intraocular lens implant (IOL).

The eye, like any other optical system, suffers from a number of specific optical aberrations. The optical quality of the eye is limited by optical aberrations, diffraction and scatter. Correction of spherocylindrical refractive errors has been possible for nearly two centuries following Airy's development of methods to measure and correct ocular astigmatism. It has only recently become possible to measure the aberrations of the eye and with the advent of refractive surgery it might be possible to correct certain types of irregular astigmatism.

<span class="mw-page-title-main">Multifocal diffractive lens</span>

A multifocal diffractive lens is a diffractive optical element (DOE) that allows a single incident beam to be focused simultaneously at several positions along the propagation axis.

<span class="mw-page-title-main">Glued intraocular lens</span> Surgical treatment for eyes lacking functional lens capsules

In ophthalmology, glued intraocular lens or glued IOL is a surgical technique for implantation, with the use of biological glue, of a posterior chamber IOL in eyes with deficient or absent posterior capsules. A quick-acting surgical fibrin sealant derived from human blood plasma, with both hemostatic and adhesive properties, is used.

Intraocular lens scaffold or IOL scaffold technique is a surgical procedure in ophthalmology. In cases where the posterior lens capsule is ruptured and the cataract has not yet been removed one can insert the intraocular lens (IOL) inside the eye under the cataract. This way the IOL acts as a scaffold and prevents the cataract pieces from falling inside the back of the eye. The cataract can then be removed safely by emulsifying it with ultrasound and aspiration. This technique is called IOL scaffold and was started by Amar Agarwal from Chennai, India, at Dr. Agarwal's Eye Hospital.

Cochrane Eyes and Vision (CEV) is a collaboration of researchers and healthcare professionals who prepare systematic reviews to study interventions pertaining to the treatment of eye disease and visual impairment. Though many of the systematic reviews focus on common eye diseases, reviews have been prepared for varied eye topics, including screening prevention and rarer eye diseases.

<span class="mw-page-title-main">Secondary glaucoma</span>

Secondary glaucoma is a collection of progressive optic nerve disorders associated with a rise in intraocular pressure (IOP) which results in the loss of vision. In clinical settings, it is defined as the occurrence of IOP above 21 mmHg requiring the prescription of IOP-managing drugs. It can be broadly divided into two subtypes: secondary open-angle glaucoma and secondary angle-closure glaucoma, depending on the closure of the angle between the cornea and the iris. Principal causes of secondary glaucoma include optic nerve trauma or damage, eye disease, surgery, neovascularization, tumours and use of steroid and sulfa drugs. Risk factors for secondary glaucoma include uveitis, cataract surgery and also intraocular tumours. Common treatments are designed according to the type and the underlying causative condition, in addition to the consequent rise in IOP. These include drug therapy, the use of miotics, surgery or laser therapy.

References

  1. Dimitri T. Azar; Damien Gatinel (2007). Refractive surgery (2nd ed.). Mosby Elsevier. ISBN   978032303599-6.
  2. 1 2 de Silva, Samantha R.; Evans, Jennifer R.; Kirthi, Varo; Ziaei, Mohammed; Leyland, Martin (2016). "Multifocal versus monofocal intraocular lenses after cataract extraction". The Cochrane Database of Systematic Reviews. 12: CD003169. doi:10.1002/14651858.CD003169.pub4. ISSN   1469-493X. PMC   6463930 . PMID   27943250.
  3. 1 2 Ong, Hon Shing; Evans, Jennifer R.; Allan, Bruce D. S. (2014-05-01). "Accommodative intraocular lens versus standard monofocal intraocular lens implantation in cataract surgery" (PDF). The Cochrane Database of Systematic Reviews (5): CD009667. doi:10.1002/14651858.CD009667.pub2. ISSN   1469-493X. PMID   24788900.