Intraocular Lens implants to correct vision

Intraocular Lens implants to correct vision

There are many procedures available to correct refractive errors, each suitable for different cases. Some are done by laser technology such as the femto lasik surgery in Egypt . Other methods such as intraocular lens implantation are suitable for different cases. In this article we will list some details about the implantation of lenses to correct the vision

How does the eye function?

The eye is the organ responsible for the sense of vision. the main structures in the eye are the cornea, iris, pupil, lens, retina, optic nerve and others , each having a distinct  function. The eye has a window, the cornea, then the lens consisting of protein located behind the pupil. As you age, these proteins change , become more opaque, and are deposited on inside the lens
laser cataract surgery   .

How does the  implantation of intraocular lenses correct vision?

The artificial clear  lenses that are surgically implanted are implanted between the cornea and the iris (in the anterior chamber) or immediately behind the iris without removing the natural lens. These correct the pathway of the incoming light rays, to focus them onto the retina, much like glasses or contact lenses but intraocular lenses  provide a permanent correction  because they are implanted inside the eye and are only surgically removed.

What are these lenses made of ?

Most intraocular lenses are made of  silicone or acrylic material. They can also be  coated with a special material to help protect your eyes from harmful UV rays.

What  are the various types of implanted lenses?

There are  several types available each with its intrinsic functions and recommendations:

I . Lenses after cataract removal: First, the most commonly implanted lenses in cataract surgeries are single-focus lenses : vision is corrected for distant objects and long distances (and the patient wears glasses for near distances

Secondly, there are the multifocal lenses , which serve to correct both near 35cm,  far distance,  and medium (60 cm distance.

Lastly there are the  multifocal-toric refractive lenses (several types) as mentioned above but they additionally correct astigmatism and are specially tailor manufactured according to each patient (6 weeks manufacturing time).

I I. Lenses implanted to correct vision in the absence of cataract (for ages 18 to 45 years) these can be either( a)single focus lenses: placed in front of the lens of the eye e.g.IPCL -ICL or (b) toric lenses (refractive): placed in front of the lens of the eye example (TORIC IPCL- TORIC ICL))

Note:

1) a person who does not have cataract,  and cannot perform lasik or femto lasik or femtosmile due to corneal issues can be  treated the same way as a cataract patient in the choice of the type of lens (monofocal – refractive  multifocal – diffractive multifocal- multifocal toric)

2) Any patient with a keratoconus that has been treated by cross linking or rings or has had a corneal transplant and has deemed stable can correct the remaining error using lenses
(ICL-IPCL)or TORICICL -TORIC IPCL.

Who are the candidates for lens implantation?

Not all patients are candidates for intraocular lens implants, as is the case with LASIK, not everyone with impaired vision is a candidate, so there is some information you should know to check if you are a candidate for lens implantation. Some of these include ages of 18 and 45. If  you are outside this age group, you may still be a candidate but you should discuss with the doctor to determine which treatment is best suited for you.

Is Myopia suitable for intraocular lens implants?

Some cases of myopia are suitable for this surgery, but only after the following has been performed

  • A thorough examination of the eye is imperative to check the readiness of the eye for the implantable IOL, the state and clarity of the cornea, and the depth of the anterior chamber to accommodate the implantable lens.  
  • The patient should not suffer from certain diseases that may affect the operation and implanted lenses such as rheumatoid  arthritis
  • Vision has to be stable and unchanged for at least a year

Pregnant women: The procedure should not be done during pregnancy.

Intraocular Lens implants to correct vision

Before the operation

contact lenses should be stopped  at least a week before the eye examinations and before the surgery because the lenses may affect the shape of the cornea, and hence the proper diagnosis of the condition.  Your  doctor will measure your visual acuity, and perform through eye exam and order certain images of the eye and cornea. this will help him to choose the type of lenses suitable for you. He may prescribe some eyedrops and also will advise you to stop taking some medications

the surgery

  • The doctor applies a special type of numbing anesthetic eye drops to your eyes to get rid of any discomfort, and the doctor may also give you after medications that help you relax
  • A special instrument is applied to help keep the eyelids open , and then another one is used to make a small opening in the cornea that does not exceed 3 mm
  • The doctor implants the lens in the posterior chamber of the eye behind the iris.
  • The whole process takes about five minutes.
  • and your doctor will prescribe antibiotic and anti-inflammatory drops.
  • You will need a ride home on the day of the surgery

Are there a risk and complications of the operation?

Any surgery comes  with a risk or complication,  although this is very rare with the intraocular lens implantation. in some cases mild bleeding, redness or swelling of the eyelid may occur. Very rarely there may be more serious complications including retinal detachment, this is a medical emergency.

Post-operative 

  • Recovery takes about a day and at this time you should:
  • Keep your eye covered even while you’re sleeping
  • You should not press the eyes and nor rub it
  • Applying medical eye drops as ordered by your doctor and using them for several weeks
  • Avoid intense exercise or weight lifting, until your doctor allows.

How will my eyesight be after surgery?

If the eye’s lens ahs been removed as in cataract cases  the mono-focal lenses  are designed to focus only on one distance, you will mostly need glasses for nearby tasks such as reading fine printing and working on a computer.

As for phakic IOL or multifocal lenses you will mostly be ale to see most ranges of distances comfortably.

What is the difference between implanting lenses to correct vision and lasik

Lasik is one of the most common types of treatments to correct error of refraction and poor eyesight namely myopia, but not everyone with myopia is a good candidate for LASIK. One of the reasons why you may not be a candidate for LASIK is short sightedness, long-sightedness or astigmatism with thin and irregular cornea or eye diseases such as keratoconus or dry eye. Research has proven that patients who underwent the intraocular lens implantation were more satisfied with the results of the operation than lasik and did not have any complications affecting vision.  These studies indicated that the intraocular lens implantation of lenses is safer than lasik in some cases

Can the patient decide which surgery to perform?

The decision of the surgical choice is not patient dependent , this is simply because there is a certain  protocol for these operations that is determined by the doctor at the time of examination, and the doctor based on his extensive experience, skill, and knowledge, decides which procedure is best for you.

Some of the most important factors your doctor considers before choosing the surgery are:

  • Patient’s age
  • The thickness and characteristics of the cornea.
  • The size of the anterior chambers of the eye.
  • The degree of refractive errors that need to be corrected

The cost of implanting lenses to correct vision

The intraocular lens implant depends on several factors you should be aware of, such as the type of lenses being implanted, the patient’s condition, the doctor’s fees, the hospital fees where the procedure is to be  performed, and also the cost of local anesthesia.

Dr. Ashraf Hassan Soliman is a consultant ophthalmologist specializing in corneal and refractive surgery, cataract and glaucoma surgery and laser vision correction in Egypt.

عن الطبيب

أستاذ طب و جراحة العيون م. طب عين شمس أستشاري جراحات تصحيح عيوب الابصار و المياه البيضاء و القرنية عضو الجمعية الامريكية لعلاج العيون و تصحيح العيون بالليزر زميل المجلس العالمي لجراحة و طب العيون زميل الكلية الملكية لطب و جراحات العيون بأنجلترا

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About the doctor

A consultant specializing in corneal, cataract and Glaucoma Surgery and Refractive surgery in Egypt, Assistant Professor of Ophthalmology – Ain Shams University, Consultant cornea, cataract, and Glaucoma Surgery and Refractive Surgery, Fellow of the Royal College of Physicians and Surgeons of Glasgow, UK.

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