Consultant Ophthalmologist,
Cataract & Refractive Surgeon

BMedSci BM BS MRCS MRCSEd MRCOpth FRCOphth MMedLaw PgD Cataract & Refractive Surgery

IC-8 pinhole IOL

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IC8 Image for Website

IC8 Image for Website 2The AcuFocus IC-8 intraocular lens extends depth of focus by combining small aperture technology with a monofocal lens. This innovative design – incorporating an opaque mini ring with a central aperture – provides cataract patients with excellent quality of vision over a broad range of distances. It effectively mimics a pin hole camera to allow clear vision at multiple distances.

Essentially, the IC-8 IOL uses the pinhole effect to exclude peripheral defocused light – which compromises image quality – and permits only central, focused light to reach the retina thereby theoretically ensuring good vision at all distances.

Patients get less glare or other light related visual disturbance. Also it works in one eye allowing me to choose a lens which suits the individual patient in the other eye.

In general, the IC-8 IOL may be applied to cataract patients with up to 1.50 D pre-existing corneal astigmatism.

 

Premium Monofocal Intraocular Lenses

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With ordinary NHS cataract surgery patients have a lens that sets them for distance. This is great for the majority but patients struggle with intermediate vision; using the computer, seeing labels on food goods, seeing the speedometer in the car, reading your phone etc.

To address this a whole new category of intraocular lens has been developed called the Premium Monofocals.

Elsewhere on this website you will see discussions about the bi-focal and multifocal intraocular lenses which are designed to give you spectacle independence for distance and near. These work well for most patients but there are downsides/compromises. If you are worried about the compromises or just want better functional vision at more distances, then the Premium Monofocals may be for you.

These lenses are monofocals so they do not have concentric rings on or split the light energy off into different place but instead work by clever optics called “spherical aberration” to give superb distance vision but also intermediate vision and some degree of near vision. They give better depth of focus and functional vision.

If we put these lenses into both eyes, then we can get good distance vision and you will be able to see the dashboard of your car and your phone/computer screen. If we do something even cleverer we can leave one eye a bit more short sighted (off-set) to give you even better closer unaided vision with both eyes open.

There are two lenses which I use in different circumstances, the Tecnis Eyhance Intraocular Lens™, and the Rayner EMV™. Both of these are delivering excellent results and a real “wow factor”, delivering greater flexibility of vision and a big impact on quality of life.

There are no guarantees and not all patients get the benefits of these lenses but the vast majority do. About 30% of patients are getting some reading vision without spectacles which is great but is not really the aim of these lenses.

I will now be offering all my private patients who need monofocal lenses the Premium Monofocal lenses.

Testimony from a patient who had Premium Monofocal cataract surgery under my care:

“I am writing to up date you following my operations which were 5 and 6 weeks ago.

Before the first operation I couldn't see clearly with prescription glasses to read from my computer screen, iPad or book and I couldn’t see clearly with my distance glasses either.

The transformation was dramatic after only one day following my first operation, and 5 weeks after the second operation I have good distance vision and can also see well in near and intermediate situations. I can easily read from a book, even in low light, and can see my computer screen and iPad without glasses, this has been possible from the first operation

I feel that I do not need glasses and can cope very well with in all situations without them. The only time that I do need help is in fine detail work e.g measurement at the millimetre level where I can see very clearly if I use off the shelf +1.5 lenses.

Overall, I am extremely pleased with the outcome which exceeded my expectations.”

Book an appointment to discuss these lenses with Mr Alwitry.

>>Find out more about the new TECNIS Eyhance Monofocal IOL in The Ophthalmologist

Extended Depth of Focus IOLs

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Extended Depth of Focus IOLsStandard cataract surgery involves removal of the cloudy lens in the eye and replacing it with a synthetic lens. This lens is called an intraocular lens (IOL) and is usually calculated to set you for distance vision in the NHS. Most people are used to wearing reading spectacles and this does not trouble them but the effect on intermediate vision is often underestimated. It is frustrating to have to wear spectacles for your computer screen or tablet as well as for proper reading. When you are out shopping having to reach for reading spectacles to read the label is frustrating. 

Extended Depth of Focus IOLs are the latest generation of premium intraocular lenses. They focus the light for distance just like the non-premium lens but they also use some light energy to give you clear vision for intermediate and, to some degree, near. They literally extend the depth of your focus/vision with minimal downside. We have the opportunity to transform the visual quality of life for the long term. These lenses can also correct any pre-existing astigmatism so even that is not a concern. 

Patient satisfaction is extremely high. 

Piggy Back Multifocal/Toric IOLs (Sulcoflex®)

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sulcoflex1sulcoflex2Sometimes cataract surgery does not give you what you want and you are left with significant astigmatism (irregularity of the cornea) or are left long or short sighted. This can leave you still dependent on spectacles when you hoped that you would be spectacle free for distance.

The new Sulcoflex® intraocular lenses are designed to be placed into the eye in front of the lens originally placed in your eye at the time of your first cataract surgery. This allows me to correct any residual spectacle dependence (long/short sightedness and astigmatism) and significantly thin your spectacles or completely get rid of them for distance.

Some patients are also frustrated by having blurred vision for intermediate and near vision after their cataract surgery. This is almost inevitable after cataract surgery with monofocal intraocular lenses. In most patients who are due cataract surgery and want good vision for all distances I utilise a Trifocal or Extended Depth of Focus lens but some patients do not have that opportunity and seek to address the issue after ordinary NHS cataract surgery. The new Sulcoflex® Multifocal is ideal in these circumstances. It is placed into the eye in front of the monofocal intraocular lens and allows near vision without spectacles in addition to the distance vision.

This is more suitable for short sighted rather than long sighted patients as there is less room at the front of the eye in long sighted patients which can result in problems with the pressure in the eye.

What are my treatment options regarding premium lenses?

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NEW: Extended Depth of Focus Lens for patients who want some degree of spectacle independence but more sensitive to visual side effects

Mr Alwitry explains what are the treatment options regarding premium lenses:

I have astigmatism. What can you do for me?

I have to wear reading spectacles as I am presbyopic. What can you do for me?

I am very long sighted. I am very short sighted. Can you help?