Refractive intra-ocular lens

"Refractive" intra-ocular lens implantation is performed when excimer laser surgery is not possible. The intra-ocular lens is placed near the natural lens of the eye (phakic implant), or replaces it.

It is important to understand that we follow the same principles for Refractive Lens Implantation as when we perform Customized Lasik procedures.  Our surgical planning aims to optimize the results with a detailed analysis of several factors:

•    What are your visual needs?  We can only counsel you on the best solution after a detailed consultation to determine your visual needs and expectations (vision at far, intermediate and near distances, activities such as work, computer, sports etc).

•    What is the potential quality of vision that can be attained considering the health of your eyes?  We evaluate the health of your complete visual system: the tear film (LipiView), optical defects of the cornea (‘corenal wavefront), and the inside of the eye (OCT testing for glaucoma and retinal diseases etc.)

•    How to optimize your results after surgery?  Follow-up of the status of the retina with ‘OCT’ scans, and adjustment of residual refraction with excimer laser at no charge.

We strive to provide you with the best possible result with the best technology available.  This is only possible with a complete examination and an in-depth discussion with you about your visual needs and expectations.

Please be assured that the type of lens we choose for your eyes is not limited by economic factors.   We do not enter into exclusivity or volume contracts with any supplier (as is often the case in most hospitals in the public system). As surgeons, we have chosen to offer the best technologies to our patients.

This is why we have established a price for the costs associated with the refractive lens surgery, to which we add our cost for the lens implant (with a small administrative handling fee). We believe that this system is clear, transparent, and avoids any possibility of conflict of interest.

"Phakic" Intra-Ocular Lens for high myopia

Implantation of an intra-ocular lens is a technique which can correct high myopia in adults who are not candidates for laser surgery.   The implant is positioned between the natural lens of the eye and th iris (ICL from Staar Surgical).


 

Lens extraction and implantation of an intra-ocular lens:

Lens extraction and implantation of an intra-ocular lens is generally performed in patients over the age of 50.  

Indications may include:
•    High hyperopia or myopia
•    Astigmatism
•    Presbyopia (with either monovision or a multi-focal implant)
•    Opacification of the natural lens (cataract)

A small incision is made in the cornea, and the natural lens is then pulverized with ultrasound and aspirated from the eye.

The next step is to implant the intra-ocular lens of the correct power.  The lens is made of acrylic, a soft and flexible material that was specifically developed for the eye.

The implant may correct at a single distance (monofocal) or at several distances (multi-focal). Also, both types of lens can also correct astigmatism

This choice of lenses allows us to offer several different solutions to our patients.

•    Distance vision in both eyes:
This solution is best for those who desire excellent distance vision in 3 dimensions (for driving and outdoor sports etc..), but they will require glasses for up close (reading, computer, hobbies, cooking etc..)

•    Monovision : 
One eye is corrected at far, and the other at near.  This approach is thus a compromise, neither perfect at far or at near, but it offers greater independence from eyeglasses for near activities. Monovision is not tolerated by everyone, depending on your visual needs.  It is important to simulate monovision fpr several days using contact lenses in order to decide whether monovision is for you.
 
•    Multi-focal intra-ocular lenses: 
This type of implant consists of concentric circles that focus light either at far or at near (bifocal lens), or at far, intermediate distance and at near (tri-focal implant). As with any other method of presbyopia correction, increased functionality comes at the price of some decrease in the quality of vision.

There is often a loss of contrast and problems with night vision (halos and glare). Mulit-focal implants are thus not indicated for those who :

o    are perfectionist in nature
o    have to drive a lot at night
o    have an eye disease that already reduces the quality of vision

For all of these reasons, once we clearly explain the benefits and risks of multi-focal lens implants, about 5% of our patients opt for this solution to correct their presbyopia.