Enhance Patient ExperienceMake Edging Lenses Even EasierVelocity Spin CoaterFully Automated Industrial Hard CoatingJeanie Premium CuttersPinnacle Lite Polish Advanced Polishing CompoundFor Consumables & PartsCobalt LTE Two Major Reasons Coburn is Right for You1 In October 2016, Coburn participated in a mission trip, bringing eye exams to a local community in the Dominican Republic. MARCH 30 – APRIL 2 New York, New York YOUR OPTICAL NEEDS IN ONE PLACEDiagnostics • Refraction • Finishing • Coating • Surfacing • Service • Consumables • SuppliesEvery year around 300,000 people undergo cataract surgery to replace the lens in their eye — it is one of the most common surgical procedures carried out in Britain.The role of the lens is to focus light rays onto the retina at the back of the eye. A cataract occurs when the lens becomes cloudy and the light becomes scattered or even blocked, causing blurred vision, halos around bright lights, reduced perception of colour and loss of night vision.
You normally have only one lens replacement operation in your lifetime, so it is vital to be well informed and get it right Usually cataracts are age-related — by the age of 60, 60 per cent of people will have some degree of cataract, but it can occur in younger people and even babies.Cataract surgery is usually performed under a local anaesthetic. First, the clouded lens is broken into tiny pieces using concentrated sound waves or, more recently, a laser. The pieces are then removed through a tunnel made in the cornea (the clear dome at the front of the eye) and an artificial lens inserted in its place. Initially, the replacement lens was simply clear Perspex, but today’s versions can also help improve vision problems.The most basic artificial lens — and the one the NHS tends to provide — is the monofocal lens that corrects one type of sight problem, either long or short sight.As most older people have a mixture of both, they still end up needing glasses, says Dr Julian Stevens, a consultant ophthalmic surgeon at Moorfields Eye Hospital, who performs around 400 lens operations every year.
Your surgeon should talk to you about your lifestyle Another option — available only privately — is to have a lens that provides distance and some near (i.e. reading) vision.The ability to correct vision this way means that lens replacement is increasingly being used by people with a very mild — or even no — cataract, as an alternative to wearing contacts or glasses or having laser surgery.There are four types of replacement lens. ‘Each has advantages and disadvantages depending on the patient’s requirements and sight issues,’ says Dr Stevens.‘Your surgeon should talk to you about your lifestyle — do you read a lot, drive a lot, play sport? All these factors should help choose the best type of lens for you. ‘You normally have only one lens replacement operation in your lifetime, so it is vital to be well informed and get it right.‘For most people this is a marvellous thing. Many of my patients become quite emotional after their operation when they realise that they can see again clearly, often for the first time in years.’
Here, with the help of Dr Stevens and Brendan Moriarty, a leading ophthalmic surgeon (and special adviser to NICE), we look at the various lenses on the market to help you make the right choice for you... As light rays enter the monofocal lens, they are bent to form just one focus point on the retina at the back of the eye. The lens will focus light coming from distant objects or from near objects, but not from both. Most people chose to have a good long-distance vision and use reading glasses for close work.Or, using a technique called monovision, a short-distance lens can be placed in one eye and a long-distance lens placed in the other. The brain adjusts to read the two distances as one.Another form of monofocal lens, known as a toric lens, is specially shaped for people with astigmatism, where the cornea is not a symmetrical shape. It’s free on the NHS and has been used safely for many years. Because there is only one point at which the light enters the lens, there are not as many issues with glare or halos as there can be with some multifocal lenses (see below).
Because this lens can correct only one focal distance, it won’t suit those who want to avoid using glasses (for instance, people who play sport and find glasses an encumbrance or do a wide variety of activities requiring near and far distance focus). Most people with short or long sight, and astigmatism. Also because these lenses provide just one focal point on the retina, they provide good vision for those with medical conditions that may have damaged the retina, such as glaucoma. Available on the NHS. If fitted privately, the procedure will cost around £2,000 to £3,000 (more if you have the operation carried out using laser technology). Concentric rings within the lens provides different strengths of vision.Rather like multifocal glasses, the brain works to ignore the rings that it doesn’t need for sight at the time. Around 95 per cent of people given these lenses no longer need glasses or have a reduced dependency on spectacles for near and far sight. Many people report a blurring where the circular rings meet each other and this meeting point can also create a sight distortion that results in night glare — difficulty seeing in the presence of a bright light such as a car headlight — and so there can be problems with night driving, so not all surgeons recommend these lenses.
Multifocal lenses are not available on the NHS and most health insurers will not pay for them. And because there’s more than one fixed focal point for the light to hit the retina, these are not suitable for people with macular degeneration or other sight conditions affecting the state of the retina. Those with short sight, long sight and with a mild astigmatism. From £2,000 to £4,000 (not including laser option). Types of multifocal lenses include Zeiss trifocal, Alcon Restore, AMO Tecnis and Rayner M-flex. This lens has an inbuilt hinge that allows it to move backward for distance vision and forward for intermediate and near vision. Manufacturers recommend that a slightly different power lens is inserted in each eye — similar to the monovision technique with monofocal lenses. An accommodating lens should mean you don’t need glasses. There are also significantly fewer blur circles or glares than with multifocal lenses with rings (see above). A risk with all cataract surgery is that the lens capsule (the thin, elastic-like bag that holds the lens) clouds up.
According to NICE, a study found that only one in eight eyes fitted with an accommodating lens required another operation to correct this within a year, compared with one in four eyes fitted with a multifocal lens. Opinion is divided over this lens type, with some surgeons very interested in these lenses and others considering them to be little more than expensive monofocal lenses with few extra advantages. All the accommodating lenses available have only a limited range of focus within each of the distance ranges and it is not yet known for how long after surgery they will continue to be able to change focus. They are more complicated to fit, with one type having tiny hooks to hold them in place as the lens moves. The other type being much larger than usual lenses so they have the disadvantage of being more difficult to remove if there are any problems. These lenses are not available on the NHS. People who need high visual quality, but who accept the range of focus change may be limited.
Between £3,000 and £5,000 for both lenses (more for laser). Brand names include Bausch and Lomb CrystaLens. The surface of this lens is completely smooth, rather than stepped as with the older multifocal lenses with rings. This gradation allows for a gradual change in focus between vision strengths, so eliminating issues such as blurring and glare caused by the distortion where two vision strength meet each other. There is some near vision, but the optimal sight is from distance to a computer monitor (or mobile phone) length away. This lens avoids the halo or blurring effects associated with the multifocal ring lenses. By not attempting to cover all distances there is good quality vision between the two ends of the range. This is the type of lens ophthalmic surgeon Brendan Moriarty recently had implanted himself after developing problems with reading, short and long sight.Brendan had rejected laser surgery due to his ‘great misgivings’ — and then when he developed a mild cataract, he had Comfort lenses put in. ‘I now have my sight restored to what it was when I was a young man, which is a fantastic result, especially as I know that this effect is permanent.’
The lens needs careful implantation — for best vision it needs accurate position in the eye — so you need to pick your surgeon wisely. Around half of people will need low-power reading glasses in low-light conditions — for example, reading a menu in a dark restaurant — but in good light this shouldn’t be necessary. These lenses can’t be used in people with a very high astigmatism, macular degeneration and for military aviators or commercial pilots or those whose priority is extremely accurate close-up vision. Not available on the NHS. Those with short sight, long sight, mild to moderate astigmastism or a combination of all three. As it is a ‘gentle’ multi-focal, it is suitable for more people than traditional multifocal lenses, ie those with vision in just one eye. Between £3,000 and £5,000 (not including laser option).For further information on Comfort lenses, visit topcon-medical.co.uk or call 01635 551120. RISKS YOU NEED TO KNOW ABOUTBetween 10 to 50 per cent of all patients who are given an artificial lens will experience some clouding of the implanted lens capsule.