Cataract is a condition characterized by the loss of transparency in the lens inside the eye. It is a degenerative disease that typically occurs with advancing age. While genetic predisposition and family history can influence the age at which cataracts develop, it is ultimately inevitable as we live longer lives. The treatment involves surgically removing the cloudy lens that obstructs vision and replacing it with artificial intraocular lenses.

This method has been successfully used for many years and has evolved significantly with advances in technology. The goal of multifocal (smart) intraocular lenses is to replace the natural lens with lenses designed to provide clear vision at varying distances—near, far, and intermediate. This allows patients to achieve a more versatile vision without the need for glasses for different activities.

Presbyopia is a condition characterized by a decline in near vision that occurs as we age. Similar to cataracts, nearly everyone over a certain age will eventually experience problems related to near vision. One of the primary causes of presbyopia is the loss of elasticity in the lens of the eye over time. As a result, the ability to switch focus between distant and near objects begins to weaken, leading to difficulties in focusing on close tasks starting from the age of 40.

Activities such as reading, writing, and doing handiwork, which typically require vision at a distance of 30 to 40 cm, become increasingly challenging, directly impacting quality of life. Currently, there are no effective laser or other treatment options available for presbyopia, and several experimental treatments have not yielded satisfactory results.

This is where multifocal (smart) lenses come into play. To address declining near vision and to provide clear vision at all distances, the natural lens in the eye can be removed and replaced with these smart lenses, which offer clarity at various ranges. When applied in suitable eyes using the correct technique, this approach can yield highly successful results.

Multifocal (smart) lenses are modified versions of the intraocular lenses that have been used in cataract surgery for decades. As previously mentioned, in cataract patients, the lens inside the eye often loses its transparency due to aging, which obstructs vision. The only effective treatment for these patients is the surgical removal of the cataract-affected lens and its replacement with artificial intraocular lenses.

Multifocal lenses, as the name suggests, are a type of intraocular lens that has multiple focal points. This allows them to provide clear vision at various distances—near, intermediate, and far—similar to multifocal glasses that enable the wearer to see at different ranges.

In recent years, these types of multifocal lenses have also become widely used to address near vision problems (presbyopia). Even in the absence of cataracts, individuals over the age of 40 may experience difficulties in focusing on close objects, significantly impacting their quality of life. For these patients, laser surgeries are not a solution, and the only alternative has been to rely on reading glasses.

The surgical procedure for multifocal lens implantation is similar to cataract surgery. The natural lens of the eye is removed, and multifocal lenses that provide clear vision at all distances—near, intermediate, and far—are implanted. This approach can help restore visual function and improve the overall quality of life for those affected by presbyopia.

The multifocal intraocular lens surgery can be performed under local anesthesia (using eye drops), sedation, or general anesthesia. The procedure can be done on one eye at a time or both eyes simultaneously. To remove the lens from inside the eye, microscopic incisions are made. The natural lens is broken down using specialized equipment (phacoemulsification) and then extracted, after which multifocal lenses are inserted.

In some stages of the surgery, cutting-edge lasers (such as femtosecond lasers) may be used to make the incisions. Because these incisions are microscopic, there is no need for stitches, meaning patients will not require stitch removal after the operation. Typically, patients can be discharged on the same day of the surgery, and hospital stays are usually not necessary.

Post-operative care involves topical treatments (eye drops). Recovery is generally quick and comfortable, allowing patients to return to their daily activities shortly after the procedure. However, since it is an intraocular surgery, patients are advised to avoid heavy sports and swimming for a few weeks.

Although vision improves significantly within the first few days post-surgery, the full expected results may take 6 to 8 months, and sometimes up to a year, to manifest fully. The procedure is designed to be long-lasting and permanent, often leading to the conclusion that patients will not need distance or near glasses for the rest of their lives.

Vision is one of our most fundamental senses. It is crucial for perceiving the world, cognitive development, and sustaining our lives. Over time, with aging and the decline of eye health, various diseases and defects can impair our vision. To continue our lives with complete and quality vision, it is essential to address these health issues and defects.

Intraocular surgeries involving the placement of multifocal (smart) lenses have become key instruments in correcting these defects. With experienced hands, proper patient selection, and the right lens choice, such surgeries can provide highly successful and long-lasting solutions.