Oliver Backhouse, Consultant Eye Surgeon www.cataract.org.uk
How to choose your lens
If you are over 40 and wishing to be free of glasses then you should consider the revolutionary high definition Mplus HD lens which has many advantages over laser vision correction. The success of this lens allows both cataract and non-cataract patients freedom from glasses for far, intermediate and near vision. Even if you are short sighted, long sighted or have astigmatism, the Mplus HD lens can give you permanent vision correction.
- Monofocal The standard lens used in cataract surgery. Glasses will be needed after.
- Tetraflex An accommodating lens. Some need for glasses after.
- Mplus HD For patients who wish to be free of glasses.
- Acri.Comfort Custom made lenses to correct astigmatism.
- Mplus HD Toric For patients who wish to be free of glasses and who have astigmatism.
- Acri.Vitalis A special lens which allows the patient to be free of glasses even if already had cataract surgery.
Why choose a Monofocal Lens?
Traditionally this has been the only lens available in Cataract surgery. A monofocal lens has a fixed distance of focus. If your point of focus following cataract surgery is for the distance then you will still need glasses for intermediate and near vision. Sometimes unaided vision for distance and near can be obtained by using the concept of Monovision. With this the dominant eye is focused for distance leaving the other eye focused for near vision. Patients can often enjoy excellent distance and near vision without glasses but some patients are not happy with Monovision as it can reduce the quality of both distance and near vision to a degree by not having the eyes focused together.
Why choose the Mplus HD Lens?
The Mplus HD lens can be used in any Lens Refractive Surgery for people with shortsight, longsight, astigmatism, Prelex (Presbyopia Lens Exchange) and for Cataract Surgery. The ultimate aim is to give you clear vision for far, mid and near-range objects without the need for glasses. This type of surgery has significant advantages over other types of refractive surgery including Laser and Monovision.
- Removal of your natural lens means you will not develop cataracts as you get older – with other types of refractive surgery such as laser you can still develop cataracts and/or have a continuing change in your prescription.
- Magnification is at a natural level.
- Full peripheral (side to side) vision.
- Permanent solution to a focusing problem.
- No upper age limit.
- Use in short-sighted and long-sighted eyes.
With a traditional 'fixed focus' artificial lens you will still need glasses to change your distance of object viewing. The Mplus HD lens is designed to produce good distance, intermediate and near vision. Unlike the Accommodating lenses available the Mplus HD lens has near and far focus built into the lens design rather than relying on the slightly unpredictable movement of an Accommodating lens to produce near vision. You are likely to enjoy useful near and far vision again without glasses or contact lenses. The Mplus HD lens has advantages over other Multifocal lenses currently available as it gives good near and far vision in differing lighting conditions independent of the pupil size as well as reduced glare / halos / contrast disturbance.
What Results to Expect
Once the decision that lens surgery will be beneficial to you, your eyes will be measured to calculate the power of the artificial lens that will give you improved vision. The Yorkshire Eye Hospital has some of the most advanced technology to allow the highest degree of accuracy when it comes to measuring your eyes. The microsurgery is performed under eye drop anaesthesia as a day case procedure through a 2.75mm wound that usually requires no stitches. This allows a rapid ability to return to work after a few days. The operation risks are the same as for cataract surgery. The second eye can be done a week after the first eye. You are likely to have the best results if both eyes have this special type of lens.
The improvement in vision occurs over the first few days and continues to improve over the weeks and months ahead. Your vision should be clearer and colours brighter. Studies have shown that over 90% have no need for glasses after with the rest needing them only occasionally. Click here for the detailed Mplus HD consent form.
Why choose Tetraflex Accommodating Lens?
The background information for using this lens is the same as that for the AcriLISA bifocal lens which you should read first. How is it different? An Accommodating lens is a new type of lens, designed to mimic your natural lens by moving subtly forward and back and changing shape as you focus, and so restoring your ability to ‘accommodate’. You will not feel the lens move ……you can often enjoy useful near, mid and far vision again without glasses or contact lenses.
Not everyone will gain the same result with this lens and unfortunately it is not possible to predict how much effect you will get before the operation. The benefit of the lens comes from the strength of the muscles inside your eye. Just as people have differing strengths of handshakes so the muscles inside the eye have differing strengths. There is therefore no guarantee that you will be completely glasses free. In fact it is likely that you will need reading glasses for sustained near vision such as reading. While an accommodating lens has been designed to provide accommodation for all eyes not everyone will see 6/6 (20/20 USA) vision at all distances. Remember, most people do not have 6/6 vision at all distances yet function quite comfortably. This type of lens has a slightly increased rate of capsule clouding which may require a Laser Capsulotomy.
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Why choose an AcriVitalis lens?
Similar to the AcriLISA lens which is bifocal and therefore allows good distance and near vision without the need for glasses, the AcriVitalis is a specially designed lens for use in people who have already had cataract surgery with a standard lens but who now wish for freedom from glasses. It is ‘piggy backed’ onto of the lens following a quick procedure under eye drop anaesthetic.
Intraocular Contact Lens - Artisan / Artiflex:
The Intraocular Contact Lens, Artisan or the foldable Artiflex, is placed inside the eye in someone who still has their natural lens. It is mostly suitable for patients who are over minus 8 dioptres of short sight (myopia) but can be used at lower refractions as well. Importantly the operation is reversible as these lenses can be removed and even replaced should your refraction change with time unlike laser which is a permanent change to the surface of the eye. It can treat very high levels of myopia - even over minus 20. These lens implants are best suited for people between 18 and 40 because your own lens still retains some ability to accommodate (changing focus from far to near). Ideally your refraction should have been stable for the past 2 years. These lenses give the opportunity to reduce your dependency on glasses or contact lenses while allowing your natural lenses to accommodate for close-up vision. They work like a contact lens, but instead of being placed on the surface of the eye, it is surgically placed inside the eye onto the iris. The disadvantage of using these lenses is that surgery is needed and annual monitoring of the endothelium (the thin cell layer that keeps the cornea transparent) is advised. In some patients problems with night vision and glare have been reported. Less glare and haloes are experienced when compared to the glare often associated with laser eye surgery.
