44 • Specialist clinics


Healthcare Innovations • Sunday 26 July 2020


Cataract surgery is an opportunity to become spectacle independent or less dependent, to correct myopia (short sightedness) and to also correct astigmatism


Advances in intraocular lens implants and surgical technology in cataract surgery


Cataract surgery is one of the most commonly performed procedures in the UK


T ere are various types of intraocular lenses (IOLs) available on the market to correct vision, and they work in diff erent ways. Laser-assisted cata- ract surgery and digital image guid- ance technology are employed for more exacting strategies. London- based consultant ophthalmic surgeon Sharmina Khan explains further with examples based on cases from her clinic.


Case 1: A 59-year old female vice-president of a company attended complaining of progressive blurring of vision and glare from oncoming head- lights when driving at night due to cataracts diagnosed by her high street optician three years previ- ously, which finally reached a tipping point. She was highly myopic in both eyes, with signifi- cant corneal astig- matism in one eye, and was keen on proceeding with surgery as her contact


lenses


were no longer able to provide her with adequate vision. She wanted to reduce her prescription and become contact lens- and spectacle-independent. She underwent bilateral femtola-


ser-assisted cataract surgery using digital image guidance, one week apart, with one eye corrected for distance with a monofocal IOL and the other, astigmatic, eye corrected for near with a monofocal toric IOL. She was delighted with her post-op- erative outcome and only required reading glasses for small print on legal documents.


Trifocal IOLs are the modern-day equivalent of the previous ‘multifocal IOLs’. T ey correct distance, intermediate and near vision and support a toric platform to correct astigmatism


Case 2: A 65-year-old male trustee of a city corporation suff ered from progres- sive blurring of his vision in both eyes. He had cataracts and astigmatism in both eyes, was very keen on spec- tacle independence and had heard of ‘multifocal lens implants’. He drove short distances locally and enjoyed gardening. After


careful selling, he


coun- under-


erative


went bilateral femto- la s e r - a ss i s t ed cataract surgery using digital image guidance, and bilat- eral trifocal toric IOL implantation, with a high post-op- satisfaction


with his spectacle inde- pendence during his


everyday activities.


Intraocular lens (IOL) types Monofocal IOLs are used widely worldwide with good, predictable outcomes and no post-operative glare or haloes. T is platform also off ers the opportunity to correct astigmatism using toric IOLs. Trifocal IOLs are the modern-day


equivalent of the previous ‘multifocal IOLs’. T ey correct distance, interme- diate and near vision and support a


toric platform to correct astigmatism. T ey should be used with caution in certain cases — for example, long-dis- tance drivers and tennis players.


Femtosecond laser-assisted cata- ract surgery and intraoperative digital image guidance Employment of both these technolo- gies further enhance a premium cata- ract surgical service by more predict- able placement of corneal incisions, optimum centration of trifocal IOLs and optimum alignment of toric IOLs. T e current literature shows non-in- feriority versus standard cataract surgery. However, both signifi cant and iterative changes over several decades has brought cataract surgery to where it is now.


The future — a 3D digital operating system using a 4K fl atscreen T is exciting technology reduces light intensity into the patient’s eye during surgery. Sharmina enjoyed enhanced visualisation of anatomic details, improved theatre team inclu- sivity and she experienced improve- ment in posture and ergonomics while operating.


In Summary Cataract surgery is an opportunity to become spectacle independent or less dependent, to correct myopia (short


sightedness) and to also


correct astigmatism. Sharmina Khan embraces innova-


tive changes in delivering eye health- care with the aim of changing people’s lives for the better by: • adopting and off ering proven new technologies


• off ering a proven track record through audited cataract surgical outcomes and patient-reported outcome measures.


SHARMINA KHAN


T: 020 7112 4921 E: info@sharminakhan.co.uk sharminakhan.co.uk


FEMTOSECOND LASER USED TO DIVIDE THE CATARACT INTO SMALL FRAGMENTS


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