No matter how successful is the phacoemulsification (PHACO) operation performed on patients with cataract, the problem of near vision in postoperative period is inevitable in all the patients that a normal lens is implanted. Our patients are obliged to use reading glasses during their daily activities like reading, writing, or using computers. This causes dissatisfaction in some of our patients. The multifocal lenses produced with the purpose of correcting this near vision problem are being used in developed countries for years, and are also used with success in our hospitals of the Alman Göz Group. These lenses must be used in patients with cataract if deemed required by the ophthalmologist. Doctor will decide whether or not multifocal lenses are suitable after detailed examinations and will recommend this lens accordingly.
While the far vision of the patients that multifocal lenses are used is highly good, we also observe that their near vision is also very good without using glasses. A patient that multifocal lens is implanted in their eye will be able to read the number of the bus approaching from far, will be able to differentiate numbers on their watch, and will who is calling from their cell phone without using eyeglasses. In our studies, 7 patients out of each 10 that we have implanted these lenses continued with their daily life without using eyeglasses neither for far vision, nor for near vision. Only a small portion of these patients felt the necessity of wearing eyeglasses for their activities In another study we performed, we saw that patients we implanted multifocal lenses had no problems in their daily lives related to their far vision. While patients that we implanted normal lenses had difficulties in activities related to near vision like reading, knitting, or using a PC without wearing eyeglasses, patients with multifocal lenses were occupied in such activities without reading glasses
Figure 1.
Multifocal intraocular lens.
very comfortably. Being able to continue with their daily lives without wearing eyeglasses for their far and near vision improves the quality of life of the patients, and satisfaction with the operation of the patients that multifocal lenses are implanted is very high. Operations for the implantation of multifocal lenses are successfully performed in our hospitals of Alman Göz Group.
Figure 2. Visions of two patients with an implanted normal lens (left), and multifocal lens (right).
Figure 3. Placement of the foldable lens
Standard technique for the modern cataract surgery of our times is phacoemulsification (PHACO). It is possible to perform the entire surgical operation through a cut of 2-3 millimeters. Thanks to this small cut, healing is more rapid and surgery is safer. Levels of vision of the patients increases in a very short time with PHACO method, and they are able to go back to their daily life almost immediately after the operation.
We have stated that it is possible to perform the Phaco surgery through a cut of 2-3 millimeters. Since lenses used today are manufactured from soft materials, and they are foldable to be placed intraocularly from this small cut. The lens placed inside the eyeball will ensure the patient to see as long as s/he is alive. This lens must be reliable, unproblematic, and must work for years, since it will remain within the eyeball for decades. However, there is a serious financial dimension of the said reliability of the foldable lens. Type of the worldwide accepted foldable lenses used in modern cataract surgery are those made from HYDROPHOBIC ACRYLIC material. It has been proven in the studies performed that these types of lenses can remain within the eye for years without causing any problems, and do not cause any problems that will seriously impair seeing functions. Approval of the American Food and Drug Administration (FDA) is one of the important indications of the reliability of the lens. Lenses produced in India in environments with doubtful conditions of production and quality are widely used in our country because of their low prices. However, it has been observed that these lenses can cause problems impairing vision after the operation and leading even to lens replacement operations. It is to the benefit of the patients that they should ask their doctors and be informed about which lens will be placed in their eyes, the material that lens is made from, and whether or not they have FDA and CE approvals. As we have mentioned above, the intraocular lens will accompany the patient throughout their life that can seriously affect the quality of life. We implant the worldwide accepted lenses produced from hydrophobic acrylic material in our patients without any exception in our Alman Göz Group hospitals. This is a standard for our Alman Göz Group hospitals. We believe that our patients deserve them.
Together with the standard we have described, new lenses are also being produced to meet the different expectations of our patients. One of these lenses is the special type of lens produced with a highly advanced laser technology with the help of the wavefront technique and used in LASIK operations today and also used in space investigations. Human lens of young health adults has been modeled in the production of this lens aiming at the improvement of both level of seeing and also functional seeing of the patient. Functional seeing means clear vision under changing light conditions when performing daily tasks. It has been shown in the studies performed that users of this lens drive safer during nighttime. The reason for this is the ability of becoming aware of the small object on and around the road before getting closer. This is an example of improved functional seeing.
