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Specialist clinics
10 MARCH 2019 • HEALTHCARE INNOVATIONS
Expert insight into the latest innovations in vision correction surgery
T ree of London’s leading ophthalmic surgeons give their expert opinion on the latest innovations in vision correction surgery
group are also exciting as the tech- nique is reversible.
Q. WHAT ARE THE LATEST ADVANCES IN CATARACT SURGERY? RA: Innovations in lens implant tech- nology and the development of multi- focal lenses mean that patients can be largely independent of glasses for near and distance vision, which gives them a lot of freedom. Our preferred lens is the trifocal lens implant, which has a great degree of patient satisfaction. At OCL, we’ve invested in some of the best available technology, including artifi cial intelligence for better lens power predictions. Femtosecond laser cataract surgery has also allowed these more sophisticated lenses to be implanted with much greater preci- sion and accuracy than ever before. It’s an exciting fi eld! AB: Multifocal lenses have
improved signifi cantly and work very well in the right patients. Bioptics — the combination of lens surgery and laser surgery — also allows us here at OCL to achieve perfect vision after surgery if our lens predictions aren’t exactly on target. AM: Rayner, a British company,
T e three experts are Mr Romesh Angunawela MD, FRCOphth, FRCSEd, Cert LRS,. Mr Ali Mearza, MBBS, FRCOphth and Mr Allon Barsam MA, FRCOphth. T ey’re all consultant eye surgeons
at Ophthalmic Consult-
ants of London, a state-of-the-art eye clinic in the centre of London that off ers the world’s best currently avail- able technology for laser eye surgery, lens and cataract surgery. All three of the experts have been voted in various UK top 10 lists for cataract surgery and laser eye surgery, and all of them work as consultants at NHS centres of excellence.
Q. WHAT ARE THE LATEST ADVANCES IN LASER EYE SURGERY? RA: Laser
eye surgery has been
performed for more than 25 years and the technology has improved signifi - cantly over that time. Recent changes have increased the speed and accu- racy of the treatment and allow us to correct higher astigmatism and long-sightedness. T e newest lasers we have at Ophthalmic Consultants of London (OCL) can correct a -5 prescription in less than 10 seconds! AM: Great advances have been
made in detecting patients who shouldn’t have surgery, which has made laser surgery very much safer. Very fast eye trackers can now follow eye movement more than 1,000 times a second and obviously this has improved accuracy signifi cantly. AB: I think custom treatments,
such as blended vision for improving reading vision, give patients very good day-to-day vision and free them from the need for glasses and contact lenses. T e Evo-lution of the SMILE procedure continues and OCL will be the fi rst clinic to off er the next genera- tion of lenticule extraction procedure with our Zeimer Z8 laser.
Q. SHOULD EVERYONE HAVE LASER EYE SURGERY (LASIK)? AB: I’ve had LASIK myself and really
enjoy the freedom it gives me in sport. I’m a fi tness fanatic and being able to ski and swim without contact lenses or glasses is amazing. RA: My sister and wife have had
laser eye surgery. Both are doctors and are very happy not to wear glasses. However, not everyone is suitable for laser eye surgery. Patients visiting the clinic will need to have an array of screening tests to ensure it’s safe to perform surgery. Also, people with conditions such as keratoconus or severe dry eye problems may need to consider alterna- tives like the Visian implantable contact lens. AM: I’ve had LASIK blended vision,
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Q. WHAT ARE THE OPTIONS FOR PATIENTS WITH VERY HIGH PRESCRIPTIONS THAT CAN’T HAVE LASER EYE SURGERY? AM: T e Visian ICL implantable contact lens is great for patients with very high prescriptions or dry eyes. It can correct very high levels of short sight (myopia). T e Visian lens has been on the market since the early 1990s. AB: Yes, the Visian
lens is a very good option for patients who can’t have laser eye surgery. Again patients need careful assessment
to check
whether they’re suitable for this type of technology.
RA: T e Visian implantable
which has been very successful. Today I can see perfectly well without glasses at all distances — I don’t even need them for reading any more. Not bad for someone in his mid-40s!
contact lens (ICL) is a great option for high prescriptions where laser eye surgery isn’t considered possible. Over one million of these implants have been used now and they have a very good safety record. New implants for people in the reading glasses age
has developed a very exciting supple- mentary lens implant — the Sulcofl ex Trifocal. It can be implanted in situ- ations where a person may already have had cataract
surgery with a
monofocal lens, but who now wants to enjoy the independence of having reading and distance vision, which a trifocal lens gives. Better still, the lens can easily removed or exchanged.
Q. IS THERE A SOLUTION TO THE DIFFICULTIES WITH READING VISION THAT SO OFTEN OCCUR AFTER THE AGE OF 50? AM: I see more and more patients opting for lens surgery before they develop cataracts to improve their reading and day-to-day vision. Modern multifocal lenses work very well in allowing patients to live without needing glasses for everyday tasks. Careful patient selection is important to get the best results, but most patients are very happy. RA: Refractive lens exchange with a
multifocal lens implant can work very well in the right patients. I usually perform this surgery using the femto- second laser for added precision. I think the new generation presbyopia correction Visian ICL lens implants are also going to be a game changer in this fi eld.
AB: Refractive lens exchange or
laser blended vision are both options depending on the person’s eyes. We try to create a bespoke solution for each and every person who walks through our doors at OCL.
Q. ALL THREE OF YOU ARE NHS CORNEAL TRANSPLANT SURGEONS AND ARE INVOLVED IN RESEARCH. IS THAT HELPFUL WHEN IT COMES TO VISION CORRECTION? RA: Being a comprehensive surgeon allows me to take a balanced view of what will work best for an individual patient and to off er them a bespoke solution to their particular vision problem. What this means is that I don’t just off er laser eye surgery, but can also consider a lens-based solu- tion if it’s required. AM: I think the ability to perform
a number of diff erent surgeries gives me the fl exibility to off er my patients the best technology for their eyes. Having an in-depth knowledge of how the eye behaves and heals is also extremely useful
in knowing what’s
safely possible and what’s going to be best for that particular patient. AB: Performing complex surgeries
such as transplants improves your overall surgical skill level. T at, in turn, benefi ts all the surgical proce- dures I carry out and also means I can off er patients a variety of diff erent solutions to suit their needs.
If you have any questions, get in touch with one of Ophthalmic Consultants of London’s experts on: T: 020 3369 2020 or E:
info@oclondon.com
Ophthalmic Consultants of London 55 New Cavendish Street, London W1G 9TF
oclondon.com
BEING A COMPREHENSIVE SURGEON ALLOWS ME TO TAKE A BALANCED VIEW OF WHAT WILL WORK BEST FOR AN INDIVIDUAL PATIENT AND TO OFFER THEM A BESPOKE SOLUTION TO THEIR PARTICULAR VISION PROBLEM
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