Intraocular Lens Implant Surgery

 

From about 1950s, researches on intraocular lenses have begun. The primary target of these researches were cataract patients, whose natural eye lenses were removed due to becoming cloudy and causing cataract; they used intraocular lenses instead of wearing thick glasses after the surgery. These lenses were made of either PMMA or silicone plastic, compatible with the eye tissue.

Today, these lenses can be implanted in the eyes in order to correct severe nearsightedness, farsightedness and astigmatism, without removing patients’ natural eye lenses. The difference between this new method and implanting intraocular lenses during cataract surgery is that in this method, the natural lens of the eye remains intact and only one additional lens is inserted in front of it. However, during a normal cataract surgery, the natural lens of the eye is replaced by an artificial lens. For this reason, after an intraocular surgery, the patient will be capable of accommodation and corrected near vision in addition to distance vision; but in the other method, there would be no visual accommodation. Therefore, bifocal lenses should be prescribed.

Note: This method is not a proper alternative for LASIK or PRK in the eyes with low myopia, but it is suitable for high myopia and greater diopters.

In Tehran-Iran Noor Eye Hospital, lens implantation is performed by highly experienced experts.

There are different types of intraocular lenses. Some of them are placed in the anterior chamber of the eyeball, behind the cornea and in front of the iris, the colored part of the eye. Some other lenses are placed in the posterior chamber of the eye on the patient's lens, behind the iris. Each of these lenses has its own advantages and disadvantages. It seems that Artisan Lenses have the best design and are offered at Tehran Noor Eye Hospital, in Iran.

 This type of lens is designed by Prof. Jan Worst and is made of PMMA. It has two arms and is fixated to the iris.

These lenses can be used to correct severe nearsightedness, farsightedness and astigmatism, which cannot be corrected by laser procedures. So far, thousands of these lenses have been used worldwide in order to correct refractive errors. The lens is permanently implanted in the eye, but it can be removed during surgery at any time.

Introduction of Intraocular Lens Implant surgery

Lens implantation is performed through a complete surgical procedure in the operation rooms of Tehran-Iran Noor Eye Hospital, but there is no need for hospitalization before and after the surgery. After anesthesia, which is usually performed in the form of general anesthesia, the ophthalmologist and the treatment team make an incision in the cornea, and then place the intraocular lens in the anterior chamber, in front of the iris and the natural lens. Finally, the incision is sutured delicately.

After 4 to 6 weeks, sutures are removed. The patient may feel a slight pain within a few days after the surgery and his/her final visual outcomes will be achieved after suture removal. There is a foldable version of Artisan Lenses called Artiflex, which is placed in the eye through a smaller incision and does not require any suturing.

ICL lens is another type of foldable lens which needs no suturing. However, it is placed in the posterior chamber on the patient’s natural lens.

 

Around 97 percent of people are expected to have a vision better than 20/40. However, this can rise to 100 percent by using glasses. The average vision after the surgery is 30/20. These lenses are available in -3 to -23 dioptric values. Myopia is correctable through LASIK only up to a maximum of around 12 diopters; therefore, it’s clear that for some people the only possible treatment for myopia is using intraocular lenses. Moreover, these types of lenses can be used for patients with extra thin cornea who are not proper candidates for laser surgery.

1. Correction of myopia up to high degrees

2. Higher accuracy in refractive error correction than laser procedures for greater diopters

3. The reversibility of the surgery by removing the lens

4. No changes in the corneal quality

5. No need for complex equipment during the surgery

6. Improved visual quality compared with glasses

7. Applicable to thin corneas

 

Common and Possible Complications

Like any other surgery procedure, Lens implantation, may be followed by common and possible complications. The advances in ophthalmology and the expertise of ophthalmologists working in Tehran-Iran Noor Eye Hospital have greatly reduced the incidence rate of these complications. However, it’s good to mention some of them as a reminder:

-Damage to the corneal endothelial and the loss of its transparency: This damage doesn’t seem to be more than other corneal surgery.

-Glaucoma: Considering that people with myopia have a greater tendency for developing glaucoma, patients should be chosen carefully. In the current studies, no particular difference has been observed in the patients who have undergone an operation for glaucoma after 3 years.

-Cataract: According to the recent studies, cataract is reported in less than 1-2% of cases. However, it takes longer to prove this.

-Lens Positioned Off-axis: If the center of the lens is not aligned with the patient’s visual axis, it is possible that his/her refractive error won’t be completely eliminated, or lead to astigmatism. This occurs when the difference is more than 0.25-0.50 mm.

-Long Recovery Period: In cases requiring sutures, complete recovery may take several weeks to several months.

 

Some other important points are mentioned to the patients by the ophthalmologists of Tehran-Iran Noor Eye Hospital .

Q: Why is lens implant recommended to some patients?

Q: Is lens implantation recommended in patients with low myopia?

Q: What is intraocular lens removal?

Q: Is intraocular implant considered as a permanent treatment?

Q: When will the suture be removed?

Q: Which lenses do not need suturing?

 

 

Q: Why is lens implant recommended to some patients?

A: If laser surgery is not applicable for correcting severe nearsightedness, farsightedness and astigmatism, lens implant is recommended as treatment.

 

Q: Is lens implantation recommended in patients with low myopia?

A: This method is not a good alternative for LASIK or PRK in patients with low myopia, but it can be used for high myopia.

 

Q: What is intraocular lens removal?

A: If due to any reason, a change occurs in the lens or the patient’s visual condition, the lens can be removed from the eye based on your doctor’s instructions.

 

Q: Is intraocular implant considered as a permanent treatment?

A: Intraocular lenses are a permanent treatment for nearsightedness (myopia), unless the lens removed from the patient’s eyes due to any reason .

 

Q: When will the suture be removed?

A: After 4 to 6 weeks, sutures will be removed. The patient may feel a slight pain within a few days after the surgery, and the final result will be achieved after suture removal.

 

Q: Which lenses do not need suturing?

A: There are a variety of foldable Artisan Lenses, called Artiflex, which are placed in the eye through a smaller incision and do not require suture. The ICL lens is also another type of foldable lens that can be implanted in the eye without suturing.