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EYE HEALTH and DISEASES SPECIALIST / FEBO / FICO
TREATMENTS
What is Smart Lens / Lens?
One of the refractive structures of the eye is the lens of the eye. Normally, when looking at close range, the refraction of the lens increases. However, after the age of 45, due to aging, lens refraction cannot increase and the problem of near vision begins. For this reason, it is necessary to use close glasses after the age of 40-45.
Today, smart lenses (intelligent lens / trifocal lens) are artificial lenses that are placed in place of the eye's own lens, aiming to show every distance without glasses.
The definition of these lenses as “smart” is a definition of our country and not a scientific definition. The main feature of smart lenses is that they are trifocal. Thanks to the first focus, far distance (driving, watching TV), medium distance (looking at the computer, phone) thanks to the second focus, close distance (reading a book) can be seen clearly thanks to the third focus.
What are the Types of Intraocular Lenses?
Cataract is the most common cause of vision loss in people over 50 years of age. The treatment is to remove the dulled lens in the eye and replace it with an artificial lens. In addition, lens surgery can be performed on suitable patients who do not develop cataracts in their eyes, but who want to get rid of both distance and near glasses.
There are many types of intraocular lenses available today.
1. Single Focal Standard Lenses
It only shows the far distance. Patients who have this lens in their eyes definitely need close glasses. If the patient has astigmatism, he also needs distance glasses. Its advantage is that its cost is lower and it does not cause light scattering.
2. Single Focal Astigmatism Corrective (Toric) Lenses
It is used in cataract surgery of patients with astigmatism. In this way, the patient does not need distance glasses after the operation. But the patient definitely needs close glasses.
3. Semi-Intelligent (EDOF) Lenses
It provides good vision without glasses at long and medium distances (60-80 cm, such as using a computer or telephone). But for close range, low prescription glasses are required. Its most important advantage is that it does not cause light dispersion at night compared to fully intelligent, 3-focus lenses. For this reason, it is more suitable for patients who work at night, such as long-distance drivers, than full smart lenses.
4. Trifocal Lenses
Its most important advantage is that it can provide glasses-free vision at far, medium and close distances. Its disadvantage is that it loses some clarity at long distances and causes light scattering at night.
5. Smart Astigmatism Correcting (Trifocal Toric) Lenses
If the patient to be fitted with a smart lens has astigmatism, the lens must also have an astigmatism corrective feature. Otherwise, the smart lens will not be able to show the desired performance.
What are the Disadvantages of Smart Lenses?
Smart lenses have the great advantage of showing any distance without glasses. It is a great convenience for a person who steals a mobile phone to be able to look at the phone without wearing his glasses, and to be able to read a text instantly, without glasses. Besides the great advantages of smart lenses, there are two disadvantages.
The first disadvantage of smart lenses is that they do some light scattering at night. This happens with more or less every smart lens. Light scattering is not felt during the day, but is felt as the scattering of other vehicle headlights, especially when driving at night. Light scattering is not a big problem, except for people who drive constantly at night. People who enjoy the comfort of seeing at close range without glasses do not have a problem with light scattering. In a significant part of the patients who have problems due to light scattering, this situation disappears within a few months (neuroadaptation). Semi-intelligent (EDOF) lenses may be a better option for people who do not want to scatter light, especially those who drive constantly at night.
Another disadvantage of smart lenses is that they cause slight contrast (sharpness) reduction at far distances. Because these lenses use about 10% of the light used in far vision for near vision. Although this feature causes a slight loss of clarity at long distances, this does not affect the daily life in most of the patients and does not pose a problem.
Who Can Wear Smart Lenses?
Smart lenses, first developed for cataract patients, are now a safe treatment method for people who do not have cataracts and do not want to use distant and near glasses due to high patient satisfaction.
When assessing whether a person is eligible for smart lens surgery, two questions need to be answered:
one. Is the patient eligible?
2. If the patient is suitable, is his eye suitable?
The profession, daily living conditions, frequency of driving at night, and expectations of the person who is planned for smart lens surgery are evaluated. Patients who are not detail-oriented and have a profession or daily life where light scattering will not be a problem are more suitable for smart lenses. But those who have professions such as the driver who has to drive at night, the watch repairman who needs to see very fine details, detail-oriented and meticulous people who magnify even the slightest problem in their lives are not very suitable for smart lenses. For these patients, semi-intelligent lenses are more suitable.
After answering the first question, the patient's eye structure is examined in the next step. In order for a smart lens to be attached to the eye, the person should not have any other problems other than cataracts and eye number. For example, diseases such as strabismus, corneal problem, macular degeneration, eye nerve weakness, eye pressure are obstacles to wearing a full smart lens. But in these patients, semi-intelligent lenses can be worn.
Can Diabetic Patients Get Smart Lenses?
In the past, smart lens surgery was not performed on diabetics. However, as a result of scientific studies, these lenses can be safely applied to patients who have not developed a problem in the optic nerves (diabetic retinopathy) due to diabetes.
How to Make Smart Lens Measurements
The most important reason for dissatisfaction after smart lens surgery is the deviation in the lens number. While small deviations in standard lenses do not cause many complaints, deviations in smart lenses disturb patients. It is possible to minimize this possibility of deviation by using a high-tech device and having surgery by experienced physicians.
Do Smart Lenses Have a Lifespan?
Smart lenses are placed in the eye during surgery and cannot be removed and reinserted afterwards. There is no change in the properties of the smart lens throughout the patient's life, and the patient continues his life by seeing all distances well without needing glasses for the rest of his life.
How Much Do Smart Lenses Cost?
It is not correct to give price information to a patient who I do not know whether or not he is suitable for the smart lens without examining it. It is more important than any situation before my patients are examined that I can decide whether smart lenses are suitable for their eyes, and by explaining the pros and cons of these lenses face-to-face, and to decide on the surgery together with the patient.
The other thing to know about smart lenses is that these lenses are not paid by SSI and multifocal (far / close together) glasses are more expensive than other glasses, and smart lenses are more expensive than other lenses. However, considering that the patient will not pay for both distance and near glasses for the rest of his life, smart lenses amortize the price paid in a short time.
Unfortunately, it is known that smart lenses and surgical materials produced in the Far East and India, which have not yet proven themselves as products in terms of quality, are used more frequently in order to reduce the cost. Risking eye health to save some on surgical supplies is murder. Moreover, the compensation of the problems caused by these materials is much more costly. To reiterate, “The patient's next vision quality depends on this surgery and this surgery is irreversible”. We should not risk our eyes, which are our most sensitive and most used sense organs in daily life, for the sake of small savings.
Smart lens surgeries make patients very happy when they are performed by experienced and ethical physicians who use clean and disposable materials, with the right measurement, on the appropriate eye, on the appropriate patient. If this issue is seen not as a health service but as a trade, it causes serious vision problems and patient grievances.