Binovision A new Approach for Seeing without Glasses Sylvia Paulig MD WOC Abu Dhabi 2012 Sylvia Paulig MD
Why did I need the Light Adjustable Lens?
I, like most of us, was far away from a precise achievement of targeted refraction in all cases. targeted refraction (standard lenses, multifocal lenses) Courtesy of Preussner, Mainz 2007
The Light Adjustable Lens allows a correction of astigmatism up to 2.00 D a correction of residual refractive errors of up to +/- 2.00 D spherical post-operatively.
From October 2008 until Jan. 2012, I have implanted the Light Adjustable Lens into 183 eyes with 93 eyes adjusted for distant vision with 55 eyes adjusted for near vision. 164 eyes are presented here, 4 patients (8 eyes) are still waiting for the adjustment. We found 27 eyes with a complicated initial situation like amblyopia, strabism or AMD (future presentation). 28.2.2009 Dr. med. Sylvia Paulig AugenPraxisKlinik Cottbus
Adjustment of Distant Vision (uncorrected) In the 93 eyes adjusted for distant vision, almost all eyes (86 out of 93), had an UCVA of 20/20 or better
Distant Vision versus Near Vision (uncorrected ) 0,9 1,3 20/20 20/16 18 26 42 0,8 = 20/25 4 3 0,6 20/32 0,4 20/50 those eyes, which had been adjusted for distant vision, also had excellent results in near vision in the very same eye. ND IV / J 5 ND III / J 4 ND II / J 3 ND I / J 2
Adjustment of Near Vision (uncorrected) ND I / J2 ND II / J3 ND III / J4 ND IV / J5 ND V / J6 ND VI / J8 ND VII / J9 in the 55 eyes adjusted for near vision, almost all eyes achieved NIEDEN I / JAEGER 2. ND VIII / J10 1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53 55 57 eye
Near Vision versus Distant Vision (uncorrected) ND I / J 2 11 17 24 ND II / J 3 ND III / J 4 1 1 1 ND IV / J 5 ND V / J 6 ND VI / J 8 ND VII / J 9 and the eyes, which had been adjusted for near vision, showed exciting results in distant vision in the very same eye. 0,4 0,6 0,8 0,9 1,3 20/50 20/32 =20/25 20/20 20/16
arc seconds WOC Abu Dhabi 2012 Sylvia Paulig MD Stereoscopic Vision Titmus-Test 40 50 60 80 100 140 200 400 800 and different from MONOVISION, my LAL patients had great stereoscopic vision. (These are our last 37 patients) eye
The LAL seems to create Asphericity
Vision in % Vision in % WOC Abu Dhabi 2012 Sylvia Paulig MD Defocus Curves different from the multifocal and standard IOLs, the defocus curves of the LALs indicate asphericity, repeatability and are superior to standard IOLs at all distances. 140 120 100 80 60 40 20 0 0-1 -2-3 -4-5 -6 5 m 100 cm 50 cm 33 cm 25 cm 20 cm 16,7 cm Diopter Defocus = Vision in distance of x cm LAL 1 LAL 2 Multifocal IOL 1 Multifocal IOL 2 Monofocal IOL
itrace demonstrates good Depth Perception of Calhoun LAL Large Pupil Circle of confusion (Zerstreukreis) focal area which is perceived as focussed and clear Large depth of field Retinal spot pattern Iris Lens Macula With a large aperture (Iris) a sharp image depends on the optimized curvature (asphericity) of the lens.
Ray Tracing Aberrometry (Tracey itrace) was done before and after Light Adjustment.
Patient 1: prior to 1st adjustment
Patient 1: after 1st adjustment
Patient 1: after lock-in
Patient 2: pre-op
Patient 2: prior to 1st adjustment
Patient 2: after 1st adjustment
Patient 2: 2 weeks after lock-in
Patient 3: prior to 1st adjustment
Patient 3: after 1st adjustment
Patient 3: 10 days after lock-in
Patient 4: prior to 1st adjustment
Patient 4: after 1st adjustment
Patient 4: 2 weeks after lock-in
Why BINOVISION? After implanting the first lenses, without glasses our patients noticed good reading, intermediate and distant vision good stereoscopic vision very good depth perception excellent quality of vision (patient reports). 28.2.2009 Dr. med. Sylvia Paulig AugenPraxisKlinik Cottbus
BINOVISION is seeing without Glasses by Modification of Asphericity of the LAL Adequate near, intermediate and distant vision in the same eye without glasses Stereoscopic binocular vision at all distances (near, intermediate and distance) superior vision compared to that provided by other lens based and refractive methods presently used
In our clinic we use the possibility of modification of asphericity of the LAL as a highly satisfying alternative for patients who desire presbyopia correction and seeing without glasses.
LAL offers the most valuable possibilities for our patients and Binovision with the LAL is the pink of perfection.
BINOVISION Seeing without Glasses The answer we ve been all waiting for.
Thank You! Paulig Augenklinik Praxis Bahnhofstraße 60, 03046 Cottbus Fon +49 355 4949720 Friedrichstraße 89, 10117 Berlin Fon +49 30 81305112 www.paulig-augenklinik.de