Many people, men and women, experience some changes in their eye health when they reach their 40s. While myopia, that is, the problem of farsightedness, is often encountered in the early stages, the problem of near vision usually occurs at the age of 45 and beyond. Pointing out that patients over the age of 45 may have eye problems such as myopia or astigmatism, Prof. from Memorial Şişli Hospital Eye Center. Dr. Abdullah Özkaya talked about what should be known about multifocal lens treatment, which can be planned jointly for the treatment of presbyopia and other eye diseases, known as smart lenses among the people.
Smart lens treatment against cataract and near vision problem
Presbyopia, which is a near vision problem, can be defined as a kind of hyperopia. This condition, which is generally seen at the age of 45 and above, may occur earlier in patients who used to wear "+" prescription glasses, who were previously hyperopic. Cataract is one of the most common eye diseases in the older age group. When cataract occurs at the age of 50 and later, first of all, the person sees far, zamIn an instant, it becomes a limitation for his close vision. In this case, "smart lenses" are recommended for patients over the age of 45 who have vision problems due to cataracts and do not want to wear both distance and near glasses. Patients with astigmatism can also benefit from needle-free and suture-free multifocal lens surgery.
You can get rid of your glasses
Two main areas of the eye are treated in order to resolve the refractive error and to get rid of the glasses. The first is the operations performed on the outer part of the eye, which is like a watch glass, namely the cornea. The second is made into the environment inside the eye, called the lens. In the age of under 40, that is, when people do not have near vision problems, procedures to stop using glasses are mostly applied to the cornea layer. Laser procedures are often applied to patients in their 20s who have distance vision problems. Especially after the age of 45, since the problem of near vision comes into play, multifocal lens surgery is applied to solve both the distance and the near. The reason for this is that laser surgeries applied to the cornea are very successful in eliminating both distance and near vision problems.
With multifocal lens surgery, modern developments in technology and the introduction of 3-focal (trifocal) lenses, very good results can be obtained in near, intermediate and distance vision. Therefore, multifocal lenses; It is a very up-to-date and effective method for patients over 45 years of age who will undergo cataract surgery and who want to wear glasses.
Appropriate patient selection is important
In all refractive interventions, a detailed pre-operative evaluation of the patient is important in terms of determining satisfaction in the post-surgical period. E.g; A 47-year-old patient who has been wearing myopic glasses for a long time and can still see far and near easily with myopic glasses may not be very satisfied with multifocal lens surgery. In particular, patients over the age of 40 who previously had hyperopia and now have problems both near and far constitute the patient group with the highest satisfaction rate for multifocal lens surgery. However, anyone who is hyperopia, has any degree of astigmatism and is addicted to double glasses can actually have this surgery.
If you have diabetes, the rules of surgery are changing
Multifocal lens surgery is not recommended for people with retinal problems, damage to the back of the eye due to diabetes or macular degeneration. The surgery of patients with controlled diabetes can be planned by consulting endocrine specialists. Because retinal problems that may develop in the long term may disrupt the comfort provided by these lenses. Again, multifocal lens surgery is not recommended for watch repairers, jewelers and long-distance drivers who work very closely due to the optical structure of multifocal lenses.
If you have astigmatism…
In addition to distance and near vision problems, multifocal lens surgery can be applied to patients with astigmatism. Astigmatism is an axial refractive error. In its simplest form, it can be explained as follows; When looking at the plus shape, patients with astigmatism see one of the vertical or horizontal axis lines more blurred. Every person has about 0,50 physiological astigmatism, but when this degree goes above 1, it creates a problem. For this reason, when multifocal lens surgery is on the agenda, especially in patients with astigmatism above the number 1, astigmatic toric multifocal should be preferred. If the patient cannot be corrected for astigmatism, patient satisfaction may be negative after surgery as both distance and near vision quality will decrease.
The corneal topography test plays a decisive role in the decision of surgery.
Multifocal lens surgery is performed with the phaco method, without needles and without stitches. Along with a very detailed eye examination before the surgery, tests measuring the patient's corneal topography and the number of multifocal lenses that need to be inserted are applied. The purpose of performing all these tests is to evaluate whether the patient needs surgery and whether he or she will benefit from surgery. These examinations and tests evaluate the presence of cataract, eye pressure, retinal condition, abnormalities in the outer surface of the cornea and curvature-related disorders. If the corneal surface of the patient is not smooth and there is any retinal disease, surgery is not recommended because it may have difficulty in adapting to the lens.
Avoid contact with water and eye rubbing after surgery.
Patients who have undergone surgery do not need to stay in the hospital after surgery. They can be discharged about 2 hours after the procedure. Water contact should be avoided for the first 5 days after surgery. Eyes should not be rubbed vigorously. While very good distance and near vision levels are achieved at the end of the first week, multifocal lenses start to show their main performance from the first month, when eye-brain harmony begins to develop and wound healing is fully established. As a result, when the patient's expectations are clearly understood and appropriate patients are selected, multifocal lens surgeries give satisfactory results.