“For a long time, refractive eye surgery has been synonymous with laser and to many potential patients, it still is,” says Goran Helgason MD of Harley Street clinic Advanced Vision Care. “As a result, some vision correction clinics have been reluctant to incorporate other technologies into practice but this is very limiting for those patients whose eyes are not suitable for surface ablation.
“However, the lens-based surgical implant options that are now available greatly increase the opportunities for both patients and surgeons to find a mutually agreeable solution to a very wide range of refractive errors.”
A driving factor behind this sea-change in the market is increasing demand from the growing presbyopic population – in other words, the baby boomer generation who are now at an age when they can’t read the small print and who do not want the inconvenience of having to keep reaching for a pair of reading glasses, Dr Helgason explains.
Knowing exactly what treatments are available and which is going to bring the results that the patient wants is increasingly important, he adds. Should they choose LASIK or PRK (laser procedures) or phakic IOLs (implantable contact lenses) or CLE (clear lens exchange)?
“There is so much information available online about corrective eye surgery that often patients have decided on a specific treatment before they set foot in the clinic. They may have chosen the right option but equally they may find that a new alternative is more appropriate.
“Unlike the one-stop-shop laser clinics, AVC has fully embraced all new technologies which means we are able to find a solution for practically every refractive error. The key to a successful conclusion is putting forward the case for each option in a way that patients can understand.
“The biggest deciding factor when it comes to patient suitability for IOLs (intraocular lenses) is the patient’s age,” said Dr Helgason. “Word has spread to patients that this technology can solve the problems of presbyopia and achieve freedom from spectacles for reading and distance vision. Many in the older age bracket, including cataract patients, who think their age precludes them from any option that corrects their refractive error, can also benefit from this option.”
At AVC, the evolution of multifocal IOLs has positioned these lenses as the first choice for treating presbyopia. Most of the common multifocal IOLs have been used for more than 10 years with very positive results. Multifocal IOLs represent excellent value for money and these are more likely to deliver spectacle freedom than with accommodating lenses. After surgery the patient is often reading well within a few days and halos tend to fade within weeks. Depth of focus, which is often better than with other multifocal models, strengthens capability and increases the ability to read a computer screen at 50-60cms.
Laser treatment remains highly recommended for higher myopia or hyperopia, however. The latest generation of lasers, keratomes and femtosecond lasers has made LASIK considerably safer, making flap complications and induced aberrations rare these days.
“Implantable contact lenses (ICL) bring remarkable results for the widest range of refractive errors,” says Dr Helgason. “The Visian ICL brand of implantable contact lenses provides impressive predictability and excellent quality of vision, even with very high prescriptions. The treatment range is remarkable, covering nearly all refractive errors from 10.00 to -18.00D, with or without astigmatism up to 5.00D.
“The fact that the procedure is reversible and that no tissue is removed seems to particularly appeal to patients. No stitches are needed and the 2mm incision in the cornea is self-sealing.
“Take it from the horse’s mouth,” he adds. “In 2004 I became a satisfied Visian ICL patient myself which has most definitely increased the trust and popularity of this technology among our patients.”