With the proliferation of electronic devices and cell phones, the eye problems associated with them have increased. With age, the natural lens of the eye loses its ability to clarify the image, which is known as white water on the eyes, but it has become accompanied by other visual defects such as myopia, farsightedness and medial vision.

In the past, the only options available to patients were either monofocal or bifocal lenses, but eyeglasses are still often required for certain activities. With the development of modern technologies, one of the most recent methods of treating cataract on the eyes is Trifocal IOL.

What are multifocal lenses for treating white water on eyes?

Trifocal lenses are the most advanced lenses for treating cataracts, as they are implanted in the eye during a cataract or lens replacement procedure.

It is a bifocal lens (Bifocal), but it was designed with the addition of a different feature in it that makes the main goal of it to provide a clear vision of the near, medium and far distances for the patient with cataract on the eyes.

What is the difference between multifocal lenses and other lenses for treating cataracts?

1- Monofocal lenses.

The most common type of lens used to treat cataracts. Unlike your natural lens, this lens features a single fixed distance focus. It means treating patients with farsightedness only, but after the operation you will need glasses for reading or watching closely.

2- Bifocal lenses.

Like bifocal eyeglasses, this one has areas that help you see things at different distances (far and near only). It may take several months for your mind to adjust for your vision to appear normal.

3- Multifocal Lenses.

Trifocal lenses work by gathering light entering the eye from near, medium, and far distances, focusing it on a single focal point on the retina. As a result, it can see objects at various distances, providing close, middle and far vision through a single lens.

This type of lens is the latest in the world of intraocular lens implantation, and it substitutes for the use of eyeglasses.

Toric IOLs are the latest in multifocal lenses

Toric lenses are eye lenses that correct astigmatism as well as nearsightedness or farsightedness.

Immediately before cataract surgery, the surgeon places temporary markers on the patient’s cornea that determine the location of the most curved meridian at the front of the eye, and then implantation of the (Toric IOL) lens during cataract surgery is performed on the eye, the surgeon rotates the lens so that the existing marks are aligned. On the lens with marks on the cornea to ensure proper astigmatism correction.

What are the advantages of multifocal lenses for treating white water on eyes?

Unlike monofocal and bifocal lenses, the design of multifocal lenses includes a third focal point (middle distance) as well as near and far distances; This is what a person requires to do daily activities such as:

1. Reading.
2. Cooking, cleaning and ironing.
3. Work on the computer.
4. Shopping.
5. Watching TV.
6. Leadership.
7. Work in the garden.
8. Doing sports.

What are the disadvantages of multifocal lens implantation for cataract treatment?

Multifocal implantation, like many modern technologies, suffers from some disadvantages, which is that patients suffer from the appearance of some bright rings around lights at night. While the patient does not see it during the day. Therefore, if you are a practitioner of night professions, Prof. Ahmed Al-Mu’tasim advises that you consult your doctor about the compatibility of the process with your profession and your daily routine.

What to expect after implantation of multifocal lenses?

After lens implant surgery, patients stay in the hospital under observation for one or a few nights. And with the use of modern surgical methods; The patient can leave the hospital on the same day. The patient is instructed on how to use eye drops that contain antibiotics to prevent infection, which he should use for 3 weeks after the operation. The patient is provided with eye drops to prevent eye infection.

Who are the candidates for multifocal lenses?

• People over the age of 55 who rely heavily on glasses.

• Astigmatism patients.

• Patients with vision disorders such as myopia or hyperopia.

• Those with age-related eye diseases such as cataracts.

However, not all candidates are suitable for all types of lenses, for example; Sometimes, the best visible results are achieved after a cataract operation with a different type of lens.

For example, you may have astigmatism in one eye than in the other. In this case, your eye surgeon recommends using an IOL lens in that eye only.

An eye surgeon can fully evaluate your specific needs during a pre-operative exam, and help you choose the best type of lens for a successful result and better vision.

The femto-ring process is considered a major breakthrough in the treatment of keratoconus with femtolizer technology, but it has become an ideal alternative to corneal grafts and corneal transplants, and has contributed in an unprecedented way to helping keratoconus owners stop the deterioration of the condition of the cornea and restore the strength of vision.

The femto-ring process is done by implanting medical rings to stabilize the corneal fibers, to reduce or eliminate myopia or astigmatism in patients with keratoconus, so that their normal vision can be restored, and there is no need for a corneal transplant.

Femto-rings for treating keratoconus

What is the femto-ring?

It is a minor surgery to reshape the corneal surface from a conical shape to a flat, natural shape, by installing specialized plastic rings that support the corneal fibers.

Stabilizing corneal microsurgery, previously used as a form of refractive surgery to treat low levels of myopia, has then received FDA approval for its use in treating keratoconus.

In this surgery, semi-circular plastic rings are used, which are inserted into the middle layer of the cornea to change the shape and location of the formed cone, eliminate some or all of the complications caused by keratoconus, and provide a good view of the various details.

However, eyeglasses may still be needed to achieve better vision, and LASIK can be performed after femto-ring to completely correct vision defects.

How does femto-ring help treat Keratoconus?

The normal shape of the cornea changes in patients with keratoconus, it becomes more curved forward (takes the shape of a cone), and this results in weak vision, and this condition deteriorates the more it is left without treatment or early intervention.

Keratoconus

And when these semi-circular rings are installed, they add volume at the edges of the cornea, and reduce their position in the middle, so they tighten and make them flat as closely as possible to the natural cornea, and this improves the strength of vision immediately.

What is the history of FemtoRing or laser corneal rings fixation?

2001: Some major medical companies manufactured specialized corneal implants to treat severe myopia.

2003: These rings received international recommendations for their use in the treatment of keratoconus due to their impressive results in tightening the corneal surface and improving vision.

2004: The FDA approved the keratoconus treatment for keratoconus.

Since that time, until now, femto-ring, or laser corneal ring fixation, has proven highly successful in treating keratoconus and some vision problems at the same time.

When is a femto-ring procedure performed for keratoconus patients?

In the past, patients had to wait a long time to reach a late stage, when it was possible to risk a corneal transplant to treat keratoconus, but now the femto-ring procedure to treat keratoconus is safely performed in the early stages.

And most of the cases that need femto-ring surgery are:

• Intermediate or advanced keratoconus.
• People with keratoconus who suffer from severe nearsightedness.
• People with keratoconus who suffer from astigmatism.

What are the steps of the femto-ring process?

This procedure involves using local anesthetic drops to numb the eye, and using a clamp to keep the eye open at all times. A semicircular ring or two is placed in the deep layers of the cornea through a small incision made with the laser beam. The FemtoRing to stabilize the cornea takes about 15-20 minutes.

The three basic steps for this procedure come in this order:

Step 1: A single small incision is made on the surface of the cornea with a laser.

Step 2: A centering instrument is placed on the surface of the eye for several minutes to help stabilize the eye and ensure correct alignment of the insertion ring. During this time, the layers of the cornea are separated at the outer edge where the rings will be placed.

Step 3: The small hole in the cornea is closed.

Follow-up visits are often needed to monitor the healing process and evaluate the visual benefits of the surgery. In some cases – even after the success of the operation – there may still be a need for medical glasses or LASIK operations to completely correct vision defects in some cases.

When does vision improve after FemtoRing?

The patient can go home on the same day, with a commitment to apply antibiotic drops and soothing eye drops that are prescribed by the doctor. The patient notices a significant improvement in vision from the first day, and it continues to improve for a period of 1 to 3 weeks.

What are the advantages of the femtogenic ring for treating keratoconus?

In fact, we can skip the word “surgery” to describe this procedure due to its extreme simplicity. And because it is completely done without any scalpel, it completely takes less than 10 minutes. Among the advantages of the femto-ring process:

1- It saves you from corneal grafts or difficult corneal transplants.
2- The cornea is raised instead of falling down, to prevent the deterioration of the condition of the cornea.
3- Helps improve eyesight and treat nearsightedness and astigmatism.
4- It has a high success rate, and it is considered a completely safe process.

Professor Ahmed El-Moatassem is considered one of the first surgeons to perform FemtoRing for more than 15 years in Egypt, the United States of America and the UAE. He is currently traveling between Egypt, Iraq and the UAE to assist various cases of treating keratoconus successfully in less than ten