Tag Archives: implant

Lens Implant Options

Posted on by
Cataract
Cataract is a foggy lens inside the eye (click image to enlarge).
Image courtesy of Caitlin Albritton.

See Eye Anatomy

Why are lenses implanted during cataract surgery?

Cataract is the name given to the natural lens inside your eye when it becomes cloudy. When cataract interferes with vision, surgery is performed to remove the cloudy lens. In order to replace the focusing power of your natural lens, a synthetic lens implant is placed inside the eye at the time of cataract surgery.

What lens implant power options are available?

The patient may choose to have the power of the lens implant adjusted to focus the eye at various distances. The power calculations are not perfect and often glasses still must be worn by many patients. Most people choose to have the lens implant focused mainly for distance. Rarely, near-sighted patients prefer to keep the primary focus at near. Standard lens implants are fixed-focus lenses. That is, they do not focus at distance and near. For example, an eye with a standard lens implant focused for distance must use reading glasses for near work.

How can we decrease our dependence on glasses after cataract surgery?

In order to decrease the need for glasses, there are options to consider, each with advantages and disadvantages. Options include bifocal contact lenses, mono-vision lens implant correction, and multifocal lens implants.

Bifocal Contact lenses: This option may be good for patients who already use bifocal contact lenses. The contacts lenses help focus at near and may refine distance vision as needed.

Mono-vision Lens Implants: In this option one eye is focused mainly at distance and one eye is focused mainly for near. Not everyone can adapt to this situation and there is slight loss of depth perception with mono-vision correction. This option is best for those who already have adapted to mono-vision contact lenses.

Multifocal Lens Implants: This is a new option offered by premium lens implants that cost more for the patient. Basically, these implants offer improved range of focus for both distance and near. Many brands are available. The choice of lens depends on how much help with distance and near vision is desired. However, the greater the range of focus a given lens offers, the greater the side effects of the multifocal lens. Side effects include decreased contrast sensitivity and glare/halos from light especially at night. Loss of contrast sensitivity makes it more difficult to see gray print on white paper. Glare and halos bother some patients more than others.

A combination of strategies may be used. For example, a low-range-of-focus multifocal lensimplant (Symfony) may be used with mild mono-visionfocusing to minimize the downsides compared with each method when used alone.

Examples of multifocal lens implants include Symfony, Restor 2.5, and Restor 3.0. There are many others. Below is a chart to demonstrate the trade-offs among these lenses.

Lens Implant Styles: Benefits and Limitations    
Style Distance vision Intermediate vision Near vision Need for reading glasses Contrast sensitivity Glare/Halos
Standard IOL (monofocal) Excellent Fair Poor Most of the time Excellent Rare
Symfony IOL Very good Good Fair Much of the time Good Mild
Restor 2.5 IOL Fairly good Good Good Some of the time Poor Moderate
Restor 3.0 IOL Fairly good Fair Good Rarely needed Poor > Moderate

If you have strong preferences, be sure to communicate with your doctor to be given the best lens implant for your situation. Keep in mind that the eye changes over time and the need for glasses may change over months to years after cataract surgery.

By Scott E. Pautler, MD

Copyright © 2018 Designs Unlimited of Florida.  All Rights Reserved.

Ozurdex

Posted on by
Ozurdex

 

What is Ozurdex and why is it used in the eye?

Ozurdex is a very small tube-like implant that contains steroid medication that is slowly released into the eye for up to 3-6 months. The Ozurdex implant is injected into the eye in the office setting in order to decrease inflammation, swelling, or leaky blood vessels inside the eye. It has been shown to improve vision in eyes with retinal vein occlusion, diabetic macular edema, and inflammation in the eye. The Ozurdex implant completely dissolves in the eye. Repeated injections may be necessary for continued improvement in vision.

How is an Ozurdex injection performed?

Anesthetics are used to make the procedure pain-free. The eye is treated with an iodine solution in an effort to prevent infection and an instrument is used to gently keep the lids open during the injection. A pressure sensation is often felt as the implant is injected into the eye with a very thin, short needle. The procedure is very brief.

What are the side effects of Ozurdex?

Although possible, it is rare to see the Ozurdex implant floating in the vision. In about 30-40% of patients, the pressure inside the eye increases and requires eye drops. About 1% of patients require glaucoma surgery to prevent loss of vision. Most eyes develop cataract and eventually require surgery. Rare risks of steroid injection include bleeding, infection, retinal detachment, and loss of vision/loss of the eye. The risk of infection is about one in 1,000 injections. Please report any severe loss of vision to the doctor without delay.

How do I care for the eye?

You may be given eye drops and instructions on how to use them. Physical activity is not limited after Ozurdex injection. Tylenol or Ibuprofen may be used if there is discomfort, but severe pain should be reported to your doctor without delay. It is normal to experience a red area on the white of the eye, which disappears in one to two weeks. If you have any questions or concerns, please call the office. Additional information is available at www.ozurdex.com.

By Scott E. Pautler, MD

For a telemedicine consultation with Dr Pautler, please send email request to spautler@rvaf.com. We accept Medicare and most insurances in Florida. Please include contact information (including phone number) in the email. We are unable to provide consultation for those living outside the state of Florida with the exception of limited one-time consultations with residents of the following states: Alabama, Arkansas, Connecticut, Georgia, Minnesota, and Washington.

Copyright © 2015-2022 Designs Unlimited of Florida. All Rights Reserved.