Cataract treatment in the UK has entered a new era with the launch of an innovative trifocal implant that overcomes the vision problems associated with current surgery techniques.
Ophthalmic surgeons at a number of centres across the country are now offering patients the chance to benefit from the AT LISA tri 839MP lens implant, which offers near, intermediate and distance vision following cataract surgery.
Today, the majority of patients presenting for cataract surgery or clear lens extraction are harder to please than those treated in previous decades
Cataracts form as eyes age and the lens begins to harden, losing its ability to focus from near to distance and back again. This is known as presbyopia and begins at around the age of 40. The earliest symptom is difficulty seeing things up close and bifocal or varifocal glasses become necessary to enable people to see clearly at all distances.
As the natural lens further ages, it starts to become cloudy and brown in colour, resulting in hazy or blurred vision and colours will often lose their brilliance. This is known as a cataract and, left untreated, it can eventually lead to blindness.
Traditionally patients who have standard artificial lenses inserted into their eye to correct the condition find they have good vision and can see far away, but their middle-distance vision, for instance when looking at a computer screen, is still blurry.
In contrast, the trifocal implant enables the patient to switch naturally between all distances, with minimal glare and haloes at night. In trials it has been found to significantly improve intermediate vision acuity without the need for corrective glasses.
Not all patients miss their middle vision with other lens implants, but some do, so it’s good to have a solution
Bobby Qureshi, consultant ophthalmic surgeon at the London Eye Hospital, which is now offering the procedure, explained: “If you imagine a dartboard with circles coming out from the bullseye in the centre, with this trifocal lens the centre circle is for focusing far away, the next for close-up vision, and the third for everything in between.
“The brain instinctively chooses which part to concentrate on and which to ignore. The patient can see near and far and everywhere around them, unlike with a pair of varifocal or bifocal glasses.
“It is an excellent option for active, short-sighted people who find glasses get in the way.”
Larry Benjamin, a consultant ophthalmologist at Stoke Mandeville Hospital, and spokesman for the Royal College of Ophthalmologists, also welcomed the innovation, saying: “Not all patients miss their middle vision with other lens implants, but some do, so it’s good to have a solution.
In my opinion, it is this one-piece, trifocal lens design that gives patients the best chance of leading a spectacle-free, active lifestyle
“The theory behind the lens is quite sound and, assuming it is positioned and fitted correctly, it should give patients an advantage for middle vision.”
The lens is implanted during a non-invasive procedure under local anaesthetic and using a computer-guided laser. This fragments the eye’s natural lens, while at the same time making an incision of 1.8mm. Through this tiny hole, the pieces of the natural lens are removed through a fine tube before the new trifocal lens is inserted. Patients can return to work the day after surgery and should notice an improvement in their vision within 24 hours.
French surgeon, Dominique Pietrini, has performed the procedure on a number of patients and said of the lens, which is manufactured by Carl Zeiss Meditec: “Today, the majority of patients presenting for cata¬ract surgery or clear lens extraction are harder to please than those treated in previous decades. Our patients now expect high-quality care, they want perfect or near-perfect vision that rivals the vision they enjoyed in their youth, and they will settle for nothing less than exceptional surgical outcomes.
“The AT LISA platform pro¬vides patients with excellent functional vision at all dis¬tances as early as the day after surgery. More specifically, it enhances intermediate vision compared with its bifocal predecessor. In my opinion, it is this one-piece, trifocal lens design that gives patients the best chance of leading a spectacle-free, active lifestyle.”
It is an excellent option for active, short-sighted people who find glasses get in the way
He added that in trials it has proved a particularly good solution for younger sufferers, telling BBH : “I have been impressed with my patients’ responses to the AT LISA tri, and patient satisfaction has been extremely high, even in the young presbyopic popu¬lation. In fact, I have noticed that results seem to be better in younger patients because they typically have a healthy retina.
“This lens does not compromise vision at any dis¬tance and the main advantage I have seen, and that patients appreciate, is that, in most cases, glasses are no longer required for computer work.”
One of the patients who has undergone the surgery said he noticed a vast improvement less than 24 hours after treatment, adding: “Every morning when I woke, I’d try to read the writing on the tennis racquets at the other end of my bedroom, and each day, it became clearer until I could read it perfectly. It is great to be able to play tennis without glasses now.”
The implants cost around £2,500 per eye.
