To evaluate the Lucidis 124M EDOF IOL for safety and post-op results in terms of intraoperative behaviour, improvement in the quality of vision and postoperative complication.
Setting:
WAPDA Teaching Hospital Complex Lahore Pakistan
Methods:
A prospective study was planned. 25 eyes 0f 21 patients with the diagnosis of cataract and no other comorbid ocular pathology were included in the study. Lucidis EDOF IOL was implanted during phacoemulsification cataract surgery over a period of 24 months from NOV 2017 to Oct 2018. Patients with intraoperative Anterior or posterior capsular rip were excluded from the study. The post-operative assessment was performed one day 1, 1 week, 1 month, 6 months and every year thereon. Quality of life was assessed by interviewing the patients at least 3 months postoperatively.
Results:
Minimum follows up was 4 months and ranged from 4-15 months. All 25 eyes had smooth Phaco and intra bag injection of IOLs with different disposable injectors supplied by the distributor. Only 6 patients had bilateral implantation. 13 patients had uniocular Lucidis IOL implantation. One patient had Refractive Rayner Bifocal in another eye. One patient was there with only eye and Rest of the 11 patients were phakic in other eyes with varying degree of lenticular changes. The unique design of this IOL haptics lead to difficulty in implantation and intra bag placement but centration was excellent.
Conclusions:
The Lucidis EDOF technology IOL appears a safe, economical and effective option for phaco IOL surgery for the patients wanting less spectacle dependence after phaco cataract surgery. However, studies with a bigger sample size and longer follow up are needed to establish this fact. Interestingly EDOF technology appears to minimize the risk of nighttime photopsia and glare. The compatible or preloaded IOL injection system is the need of the hour to save intraoperative manipulation and implantation of the IOL.
Financial Disclosure:
None
Video-Phaco with Lucidis Edof IOL Implantation using Contamac Ergotouch Injector
Phaco with Lucidis Edof IOL Implantation using Contamac Ergotouch Injector Surgeon and Producer Professor Mazhry
Video-Phaco with Lucidis Edof IOL Implantation using Contamac Ergotouch Injector
About Eye Health Education By Acuity Eye Center Lahore Pakistan:
Welcome to the Education Portal of Acuity Eye Centre Lahore Pakistan. We are committed to serving our patients and our community, to the development and propagation of new concepts to preserve and enhance vision. Our three missions—clinical service, education, and research—are closely interrelated. Visit:https://eyeacuity.com/education/
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Dear Colleagues/Residents in Ophthalmology Assalamalaikom, Jinnah Hospital Allama Iqbal Medical college and WAPDA Teaching Hospital Lahore invite you all to attend "Phaco Cataract Course-Basics and Advanced". The course consists of 15 lectures, planned to be delivered by Associate Professor Zia ul Mazhry every thursday 9.00to10.00am PST. The activity will be conducted during weekly seminar at Eye Department Jinnah Hospital Lahore under motivation, patronization of Professor Nadeem Hafeez Butt. The series will be presented from 1st of August 2019 till end of Nov 2019. The lectures will be streamed live on OnlineSummit.org. Please go ahead and book your place now in one of its own kind, comprehensive phaco cataract IOL course series.
June is Firework Eye Safety and Cataract Awareness Month
Approximately 25 million Americans have cataracts, which causes cloudy, blurry or dim vision and often develops with advancing age.The incidence appear even higher in Pakistan. This June, the Acuity Eye Center Lahore Pakistan joins the American Academy of Ophthalmology in observing Cataract and Firework Eye Safety Awareness Month by sharing three things everyone should know about the condition and its treatment.
As everyone grows older, the lenses of their eyes thicken and become cloudier. Eventually, they may find it more difficult to read street signs. Colors may seem dull. These symptoms may signal cataracts, which affect about 70 percent of people by age 75. Fortunately, cataracts can be corrected with surgery. Ophthalmologists, physicians who specialize in medical and surgical eye care, perform around three million cataract surgeries each year to restore vision to those patients. Get an idea of what someone with cataracts might experience with this cataract vision simulator. The following are facts people should know about the condition.
Three Things Patients Should Know About Cataracts
1. Age isn’t the only risk factor for cataracts
Age isn’t the only risk factor for cataracts
Though most everyone will develop cataracts with age, recent studies show that lifestyle and behavior can influence when and how severely you develop cataracts. Diabetes, extensive exposure to sunlight, smoking, obesity, high blood pressure and certain ethnicities have all been linked to increased risk of cataracts. Eye injuries, prior eye surgery and long-term use of steroid medication can also result in cataracts. If you have any of these or other risk factors, talk to an ophthalmologist.
2. Cataracts cannot be prevented, but you can lower your risk
Wearing UV-blocking sunglasses and brimmed hats when outside can help. Several studies suggest that eating more vitamin C-rich foods may delay how fast cataracts form. Also, avoid smoking cigarettes, which have been shown to increase the risk of cataract development.
3. Surgery may help improve more than just your vision.
During the procedure, the natural clouded lens is replaced with an artificial lens called an intraocular lens, which should improve your vision significantly. Patients have a variety of lenses to choose from, each with different benefits. Studies have shown that cataract surgery can improve quality of life and reduce the risk of falling. If cataracts are interfering with your ability to see well, consider asking your ophthalmologist about cataract surgery.
A life-changing surgery.
Sometime after age 50, most of us are likely to hear our eye doctor say, “You have cataracts.”
A cataract is a clouding of the lens inside the eye, causing vision loss that cannot be corrected with glasses, contact lenses or corneal refractive surgery like LASIK.
As frightening as cataracts might sound, modern cataract surgery usually can restore vision lost to cataracts — and often can reduce your dependence on eyeglasses as well..And the prevalence of cataracts around the globe. is expected to grow significantly in the years ahead, due in part to the ageing of the population.
"Cataract are the most frequent cause of vision loss in people over the age of 40 and the leading cause of blindness worldwide.There is no way to completely prevent cataract from forming but you can reduce your risk by wearing sunglasses, eating a healthy diet ,getting exercise and avoiding tobbaco products. Timely intervention through regular eye examinations is an ultimate answer to your cataract related vision problem."
Seniors concerned that they may have cataracts may qualify for a no-cost eye exam through EyeCare America, one of largest public service programs in American medicine, is a program of the American Academy of Ophthalmology that provides eye care through a pool of more than 5,000 volunteer ophthalmologists. Ninety percent of the care provided is at no out-of-pocket cost to the patient. The program is co-sponsored by the Knights Templar Eye Foundation, Inc., with additional support provided by Alcon and Regeneron. For more information, visit eyecareamerica.org
About Eye Health Education By Acuity Eye Center Lahore Pakistan
Eye Health in urdu by Acuity Eye Center
Welcome to the Education Portal of Acuity Eye Center Lahore Pakistan. We are committed to serving our patients and our community, to the development and propagation of new concepts to preserve and enhance vision. Our three missions—clinical service, education and research—are closely interrelated.
Recent Advances and Innovations in Cataract Surgery
Professor Zia ul Mazhry
Recent Advances and Innovations in Cataract Surgery
OSP KPK honoured Professor Doctor Zia ul Mazhry as he was invited to deliver a talk in plenary session of Khyber Eye Con 2019. The topic was "Recent Advances and Innovations in Cataract Surgery". This prestigeous session was chaired by living legend Professor Dawood Khan. It was really a great oppertunity to present and talk along with international speakers like Professor Babar Qureshi and Professor Carlo Schonfeld from Germany. The summary of the talk with glimpses is presented in this article.
Discussion Plan
The Cataract Treatment Strategies
The Concept of Neuroadaptation
Innovations and Advances in Cataract Diagnosis
Trends in Cataract Surgery
The Pursuit of an Ideal Intraocular Lens
Innovations to Manage Challenging Cataract Cases
Prevention and Management of Complications
Summary and Conclusion
Section -1
The Cataract Treatment Strategies
Uniqueness of The Crystalline Lens
Cataract Surgery in Antiquity
Cataract – Can it be Prevented or Slowed ?
No definitive proof that intake of vitamins or nutrients or ‘catalina’ eyedrops decrease incidence of cataract
Anatomic Types of Cataract & Their Visual Implications
Cataract is an Age Related Eye Disease
Treatment Strategies
When cataract mild, a change in eyeglasses helps vision
In patients with more advanced cataracts or in patients with glare, surgical treatment is indicated
Cataract Dissolving Eye Drops reported Successful in Dog Eyes
Section - 2 Neuroadaptation
خود ہی تو کہتے تھے مجھے خود کو بدل لو
بدلا ہوں تو کہتے ہو کہ اب وھ نہ رہا میں
آنکھ سے اک روز بے حد ناز سے بولا دماغ
عقل کی اندھی ہے تو الٹا نظر آئے تجھے
آنکھ بولی میں نہیں تو الٹا سیدھا کچھ نہیں
میں ہوں دریچہ نور کا کون سمجھائے تجھے
Lens Changes and Psychophysics of Vision
The image on the top left was painted when Monet had a moderately progressed cataract (1915), and the image on the top right provides us with the perspective of how Monet would have seen the picture. The lower image shows us the great detail and contrast that Monet was capable of seeing, and subsequently creating, once the cataract was removed in 1926
Section -3
Innovations in cataract Diagnosis
Advances in Diagnosis and Pre Op Planning
The Biometric Accuracy
Understanding of Corneal Biophysics
Role of OCT
Intraoperative Aberometery
Section -3-B
Advances in Cataract Surgery
Cataract Surgery
Most commonly performed eye surgery
Among most successful surgeries that can be performed on the human body.
Still Not a procedure without risk.
Topical Anesthesia, out-patient procedure
What Criteria are Most Important to Surgeons
Wound size and Construction
Rhexis Techniques and Centration
Phacoemulsification
Ease of Insertion of IOL
Optical Quality
Biocompatibility
PCO rates
YAG Resistance
Post-op Inflammation
Dysphotopsias
Wound Construction
Location
Size
Contour
Neutral
Capsular Rhexis
Rhexis Margin
The Rhexis
Needle Assisted
Forceps Assisted
Femto/Zapto/RF Assisted
Femto CCC
Most advanced way of making a perfectly sized, absolutely circular CCC
Depth and diameter of CCC is determined by OCT and rhexis done automatically
The detached flap is manually removed by forceps
Hydrodissection/ Hydrodelineation
Phacoemulsification
The greatest fear known to man is a new idea.
Phacoemulsification was first introduced in 1967
1969 “Charlie has produced an operation which will take all the fun out of cataract surgery.”
1974 “The use of the phaco machine for the removal of a cataractous lens is analogous to the shooting of game birds with guided missiles.”
If you have strong reasons to believe in your ideas, have confidence—face the brickbats and go ahead.—Harold Ridley, MA, MD, FRCS.
Evolution of Phaco
The 1960s - The Beginning
The 1970s - Moving Posteriorly
The 1980s - The Capsulorrhexis Era
The 1990s - The Era of Reduced Emulsification Energy
From 1985 to 1995- a “dramatic phaco revolution” The less than 10% of surgeons using phaco in the early 1980s rocketed to 95% by 1995.
The 2000s - An Era of Alternative Energies and Further Reduction of Ultrasound Energy
Phaco with Preloaded RayOne Hydrophilic aspheric Implantation
Refractive IOLs involve the same skills set as that of cataract surgery
Multifocal and accommodating lenses are dramatically changing the way all eye doctors practice refractive surgery
Recent Advances in Cataract Surgery
Cataract Surgery may be looked upon as an opportunity to give patients freedom from eyeglasses
This is possible with the use of newer IOLs that focus light at most distances
(these lenses are multifocal as opposed to previous lenses which are monofocal)
The Mindset
Patients are interested in lifestyle, not pathology and are happy to pay for the enhanced quality of life
Old paradigm: Patient want to see better than they did with their cataracts
New paradigm: Patients want to see better than they did before they developed cataracts
Presbyopia IOL options
Monovision
Refractive
Diffractive
Accommodative
Extended depth of Focus(EDOF)
Multifocal IOLs-The basics
Diffractve
Refractive
Diffractive Refractive
Extended Depth of Focus
Accomodative
The focality
Monofocal
Bifocal
Trifocal
Panfocal
EDOF
Variable Focus
The Concerns
problems with intermediate vision
reduced contrast sensitivity
halos
glare
‘Vaseline vision’ / waxy vision
reduced tolerance to astigmatism
Combining Economy with Quality
LUCIDIS is an advanced monofocal lens designed to correct the vision post-cataract surgery. Raising the standard of the IOLs, LUCIDIS ideally combines the proven robustness of the monofocal lenses with the unprecedented performances of the revolutionary EDOF technology “Instant Focus”.
The future
Configure Your Lens
https://sav-iol.com/products/harmonis/
Lenses with Variable Focus
Shifting fluid from haptic Pockets
Minimizing Glare halos and Dysphotopsia
Sifi Miniwell Progressive with EDOF Technology
Refractive Lens Exchange
New IOLs have an out-of-pocket cost similar to LASIK surgery
Considerable freedom from eyeglasses possible with these IOLs
Some surgeons/patients extend the above to patients who don’t have a cataract but want freedom from reading glasses (Refractive Lens Exchange)
Section - 7
Innovations in Management of Challenging Cataract
Cataract Challenges
Phaco of a dense hypermature cataract using Dye Staining
Clinicians wishing to undertake implantation of multifocal (non-accommodative) IOLs during cataract surgery should ensure that patients understand the risks of the procedure, including the possibilities of halo and glare, and reduced contrast sensitivity. Patients should also be made aware that the lenses may be difficult to remove or replace. They should be provided with clear written information.
Cataract - Summary
Cataract Surgery only when patient bothered by existing vision
Cataract surgery among most successful surgical procedures but is not without risk
Cataract - Summary
Cataract surgery is an outpatient procedure done using local anesthesia and involves removal of cataract with Ultrasound and placement of IOL
For patients desiring freedom from eyeglasses, options of new IOLs available
Conclusion
Innovations in IOL design and phacoemulsification instrumentation have potentiated:
improved surgical outcomes,
reduced perioperative morbidity
and increased likelihood of spectacle independence.
As a result, surgeons are attaining unprecedented safety, efficiency and precision.
The Whole Package
Rapid, Safe, Smooth Two Handed Surgery with time tested lens implant aiming at true spectacle independence. Remember that you are now a refractive surgeon
Contact Our Team:
If you are looking for any of below services, please fill the form below, one of our team member will get in to provide you with full facilitation:
1- Comprehensive Primary Eye Exam/ Consultation
Consultation ::: Adult Eye Examination and Consultation Consultation ::: Children Eye Examination Refraction Consultation Consultation ::: Infant Eye Examination Refraction Consultation 2-Secondary Follow up Eye Exaamination and Consultations
Followup ::: Examination under Sedation for Kids (After Initial Consultation) Followup ::: Dilated Fundus Examination(DFE) Followup ::: Cycloplegic Refraction and DFE 3-Diagnostic Eye Test
Diagnostic ::: OCT Diagnostic ::: Angio OCT Diagnostic ::: Anterior Segment OCT Diagnostic ::: Pachymetery Diagnostic ::: Perimetery/Visual Fields Diagnostic ::: Hess Chart/Digital Squint Assessment/Digital Diplopia Test Diagnostic ::: Digital Colour vision test
