Key words: cataract and refractive surgery, spectacle independence, intraocular lenses, safety

"Safety and Efficacy of Intraocular Lenses in Cataract - and Refractive Surgery"

There is a global rise in the number of people with high myopia. These patients rely heavily on glasses or contact lenses, and rarely qualify for laser refractive surgery. Use of an implant lens can be beneficial in these situations: placed between the cornea and patients’ lens they offer excellent refractive correction and visual acuity. Our research has shown that as a foreign body, they can be associated with increased ageing of the cornea and patients’ lens, with safety varying amongst lens types. Lenses that use the irido-corneal angle for support have short-term safety concerns for the cornea, whereas iris-fixated lenses can be used safely after modification of the implantation criteria and follow-up schedule. The second part of the thesis focuses on middle-aged patients: their lens loses accommodative power as they age, resulting in the need for reading glasses. This thesis shows that spectacle independence can be obtained in these patients by implanting a multifocal lens during cataract surgery. Implantation of trifocal lenses or a combination of two types of bifocal lenses both result in spectacle independence. However, in some cases this may be associated with side-effects like photopsia and loss of contrast.

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