Akıllı Lens

With advancing technology, there has been a significant progress in the lenses used in cataract surgeries. Trifocal lenses, also commonly referred to as ‘smart lenses’, are designed to go beyond a single focus problem to solve multi-focal problems. These lenses go beyond traditional methods of correcting refractive errors, allowing patients to see clearly at both near and far distances.

Trifocal lenses also offer a solution for patients with refractive error for whom laser treatment is not suitable. These lenses provide a comprehensive vision improvement, allowing patients to lead their daily lives more comfortably without glasses. Post-operatively, patients achieve clear vision at far and near distances and can successfully perform a range of tasks.

This innovative technology is an important step in the field of eye health and significantly improves the quality of life of patients. Trifocal lenses have the potential to provide clear and comfortable vision to more people, replacing the traditional lenses used in cataract surgery. In this way, patients can fulfil their daily activities more easily while improving their quality of life.

Eye health is vital for quality of life and modern lifestyles make clear vision even more important. Especially today, activities such as using computers, watching television, looking at mobile phone screens and reading books form an important part of our daily routines. However, with age, especially after the 40s, eye flexibility decreases in many people and problems such as nearsightedness occur.

Glasses and contact lenses are frequently used solutions to deal with nearsightedness. However, some people may not prefer or find these methods appropriate. Also, laser treatment is generally not suitable for people over the age of 45. In this case, ‘Clear Lens Extraction’ or clear lens extraction stands out as a recommended treatment method. This method reduces the risk of cataract problems in the future, while at the same time allowing patients to obtain clear vision at near, medium and long distances.

Another common problem, especially in advanced ages, is cataract disease. While cataracts may initially cause problems in distance vision, they may also cause deterioration in near vision over time. For a permanent solution, it may be necessary to surgically remove the natural lens of the eye and replace it with an artificial intraocular lens. This procedure can also be used to treat presbyopia (nearsightedness).

Intraocular lenses come in different types and are named according to their focal point. Monofocal (single focus), bifocal (bifocal) and trifocal (trifocal) lenses are used to meet different needs and help improve patients' quality of life.

What is a Smart Lens? (Trifocal Intraocular Lens)

Smart lenses are trifocal intraocular lenses that are generally preferred in the treatment of cataract patients over the age of 40, allowing patients to achieve clear vision at far, near and medium distances. These lenses significantly improve the quality of life of patients by eliminating the need to wear glasses after the operation. Smart lenses, also known as trifocal lenses, represent an important step in the treatment of eye defects and offer patients a wider range of vision.

Why Smart Lenses are Needed?

Every human eye has a natural lens and this lens has a transparent and flexible structure. In this way, every time the eye looks near and far, the lens can change its shape thanks to its flexibility and focus on the distance viewed. This mechanism provides clear vision at both near and far distances.

However, with age, the flexibility of the natural intraocular lens decreases. In this case, when looking close, the lens becomes unable to change its shape and we cannot see the near clearly. Over time, cataracts can form at older ages as the lens loses its transparency.

Around the age of 40, when the natural intraocular lens begins to lose its flexibility, it can be replaced with an artificial lens. The deformed natural lens is replaced by an artificial lens, the so-called smart lens. This new lens can focus both near and far and provides clear vision at intermediate distances. The risk of cataract formation in the future is reduced in patients with smart lens implantation. In this way, the quality of life of patients increases and the need to wear glasses decreases.

How Do Smart Lenses Work?

The natural lens in our eyes refracts light from different distances and combines it into a single focal point on the retina so that we perceive the image. In this process, our natural lens fulfils this function by stretching itself to different focal points. Trifocal intraocular lenses are based on the same principles. These lenses allow focusing light from far, near and medium distances with a single lens. Smart lenses offer the opportunity to make appropriate adjustments to the focal distances where the person has focusing problems. In addition, these lenses can be customised according to the person's eye type. In this way, they provide maximum visual comfort to the user by eliminating the need for glasses with multiple different distances.

What are the Areas of Use?

Smart lenses are used in the treatment of cataract disease caused by the loss of transparency of the natural eye lens or in the treatment of patients with age-related nearsightedness. It is a permanent treatment method for both cataract and age-related nearsightedness. These treatments are based on the principle of removing the natural eye lens from the eye and replacing it with an artificial intraocular lens.

What Are Multifocal Intraocular Lens Types?

Monofocal lenses are lenses that allow us to see clearly at a single viewing distance.

Bifocal lenses are lenses used for both near and far vision and have two different focal points.

Multifocal lenses are lenses that provide clear vision at near, far and medium distances.

Trifocal lenses, known as smart lenses, i.e. multifocal intraocular lenses, allow us to obtain clear vision at near, far and medium distances. These lenses are designed to provide clearer vision at different focal points of the eye, allowing patients to have a wide range of vision.

To Whom Can Smart Lens (Intraocular Lens) Treatment Be Applied?

The smart lens operation is similar to the method used in phaco cataract surgery. However, replacing the natural lens with a trifocal intraocular lens and then removing it again is a risky and unnecessary procedure. Therefore, various examinations should be performed before surgery to determine the patient's suitability. The purpose of the smart lens is to provide the patient with optimum quality vision at all distances.

The preoperative condition of the patient is also important for the success of the operation. For example, this condition should be corrected in patients with dry eye problems. In addition, patients with conditions such as macular degeneration, advanced eye pressure or diabetic retinopathy are not suitable for smart lenses.

The patient's eye anatomy is also a determining factor for the operation. In particular, the distance between the visual axis and the anatomical axis of the eye must be in a certain ratio. This ratio can be measured with optical biometry devices.

Are Smart Lenses Permanent?

Yes, smart lenses are permanent. The patient's eye number is fixed with intraocular lenses. Once these lenses are placed in the eye, the patient can use these lenses until the end of his/her life. In other words, there is no deformation in these lenses depending on the age of the patient. For this reason, it is critical that the patient undergoes detailed examinations before the treatment and the correct determination of the eye number is critical.

How to Perform Smart Lens Compatibility Test?

Before the smart lens operation, various eye test applications and examinations are performed according to the patient's complaints. In these examinations, it is examined whether the patient has cataract or refractive error problems.

Firstly, a general eye examination is performed for about 30 minutes. In this examination, visual acuity test and measurement of refractive errors are performed. Afterwards, the power of the intraocular lens is determined by biometry. Methods such as SPM, USM can be used in the detection of cataract disease and in the process of suitability for the operation.

In addition, methods such as tonometry, OCT, HTR are used to determine whether the patient has a problem in terms of eye pressure. Finally, a fundus examination is performed to determine the presence of any retinal problems. Because glaucoma disease and diseases such as macular degeneration and diabetic retinopathy eliminate the possibility of smart lens treatment.

At the end of all these examinations, if the patient is suitable for trifocal intraocular lens, the patient is given an appointment for surgery.

How is Smart Lens Operation Performed?

Smart lens treatment is the process of placing a multifocal lens in patients with cataracts during surgery. Thanks to this method, the need for glasses after surgery is eliminated. The operation can be performed in eye hospitals and eye centres.

People who do not want to use glasses and who are over the age of 40, people who have distance and near vision problems and are not suitable for laser treatment, even if they do not have cataract problems yet, early cataract surgery can be performed and vision problems for different distances can be solved by placing a smart lens.

The surgery is performed by phacoemulsification method. Each eye is subjected to a procedure lasting about 10 minutes on separate days. First, the eye is numbed with anaesthetic eye drops so that patients do not feel pain or soreness during the procedure. General anaesthesia or hospitalisation is not required. During the operation, multifocal intraocular lenses are inserted into the socket of the lens inside the eye. After the operation, the eye is bandaged and patients can go home. The eye remains bandaged overnight and the bandage is removed the next day. The patient starts to see the same day. The same procedures are performed for the other eye in a few days and the treatment is completed.

Multifocal Intraocular Lens Use in Cataract Surgery

In cataract surgeries, monofocal or bifocal intraocular artificial lenses were generally used in the past. Today, however, the use of trifocal intraocular lenses is becoming increasingly common. This is because clear vision can be achieved at all focal distances with a single lens. Smart intraocular lenses offer a permanent solution in cataract treatment.

Trifocal lens application is performed with the Phaco Method in cataract surgeries. The operation starts with numbing the eye with anaesthetic drops. Generally, general anaesthesia is not applied except in special cases. Firstly, the natural lens in the eye that has lost its transparency is removed. Then, the smart intraocular lens is inserted into the socket. The same procedure is performed on the other eye a few days later and the treatment is completed.

What should be considered after the surgery?

Regular use of eye drops prescribed to patients is an important issue. Care should be taken not to lie face down for the first week. For 5 days, the eye should not be in contact with water. Patients can return to their routine work life after 2 days. The next day, the first control of the patient is carried out by the physician. Routine controls continue after one month and 6 months.

What are the Risks of the Operation?

During the operation, full sterilisation is provided to prevent the eye from getting infected. In addition, the success of the operation is directly proportional to the quality of the lens used and the experience and knowledge of the physician performing the operation. Of course, like every surgery, smart lens surgery has various risks. However, when the optimum conditions are provided, these risks are minimised and the operation can be successfully completed.

What is the Importance of Multifocal Intraocular Lens?

The most important feature of smart lenses is that they provide vision at intermediate distances. Vision is also provided at distances where the quality of vision should be the most important, such as computer usage distance, television viewing distance, access distance to the kitchen counter.

What are the Advantages of Smart Lenses?

It is an operation that helps people with refractive problems such as myopia, astigmatism and hyperopia, as well as cataract problems, to see in a healthy way again. Smart lenses are decided whether to be placed in the patient's eye as a result of the evaluations made by ophthalmologists through various eye examinations. In addition to the eye problem experienced by the person within the scope of this evaluation, factors such as the age and general health status of the person are also taken into consideration. The treatment is started as a result of the patient's acceptance. The advantages of smart lenses are as follows:

• Patients do not feel any pain or ache during the operation.
• It is an operation that can be completed in 10 minutes on average.
• Intraocular lenses inserted as a result of the operation can be used for life.
• There is no progression in the eye numbers of the patients after the operation.
• Thanks to smart lenses, multiple focal distances can be seen without wearing glasses.
• With the use of smart lenses in the treatment of eye diseases such as cataracts, cataract formation does not occur again in patients.
• In some refractive problems, it can be applied to patients with advanced eye numbers that cannot be corrected with laser treatment.
• As a result of the operation, a significant increase in the quality of vision is observed.
• As a result of intraocular lens operation, the patient does not need to be hospitalised.