Achieving spectacle independence or reducing spectacle dependence is a goal for many of our patients undergoing cataract surgery and it is almost always the goal with refractive lens exchange. At Fendalton Eye Clinic we have been offering lifestyle lenses since the late 1990s. There is no intraocular lens that can perform like a 20 year old natural human lens and with every option there are some compromises or side effects.
Each patient is different in what they would like to achieve and which compromises might suit their individual life style.
Fendalton Eye Clinic offers two methods of reducing dependence on near vision spectacles after cataract surgery or refractive lens exchange with intraocular lenses (IOLs).
These IOLs have three focal points for distance, intermediate and near vision. They split light rays to the three focal points using diffraction grating technology. Trifocal IOLs are best suited to people who want the maximum possible freedom from spectacles but are prepared to tolerate night vision disturbances including halos around lights and starburst (a light looks like a large star). I’ve found a high level of patient satisfaction with the Zeiss trifocal IOL in patients who want to be able to see all distances without glasses and are happy to tolerate or adapt to night time halos.
With a unique asymmetrical light distribution of 50 %, 20 % and 30 % between far, intermediate and near foci, AT LISA trifocal is able to provide more satisfying and predictable visual outcomes across three areas rather than the traditional 2 zone focusing multifocal (like the two zone ReSTOR multifocal and Tecnis Multifocal). The Zeiss trifocal IOL has three focal points – infinity, 80cm and 40cm. The Zeiss trifocal is currently the most popular trifocal IOL used world-wide.
This IOL is very similar in design to the Zeiss trifocal IOL and the intermediate and near focal points are at similar distances. There is very little to choose between the FineVision trifocal IOL and the Zeiss trifocal IOL according to European eye surgeons that have used both IOLs.
This trifocal IOL was released in 2015 and is based on the Alcon AcrySof IOL platform. The main difference compared to the Zeiss and FineVision trifocal IOLs is that the intermediate focal point is closer at 60cm rather than 80cm. I’m not convinced that this closer intermediate focal point is any particular advantage in real life situations and it appears to function much like the Zeiss and FineVision trifocal IOLs. I first used the AcrySof IOL in 1995.
Introduced in 2017 by Zeiss, the AT LARA trifocal IOL is designed to provide good far distance and intermediate distance vision with fewer issues for night driving than the three trifocal IOLs listed above. While it still causes some night time halos around lights, the halos are less marked and therefore easier to adapt to. The disadvantage of the AT LARA is that the reading focal distance is further away and so reading glasses are more likely to be required.