New technology allows you to see near & far without glasses!
See Near and Far and everything in between without the need of any visual aids.
Say Bye Bye to Trifocals, Bifocals and goodbye Readers too.
While bidding adieu, say good riddance to contact lenses too.
Imagine getting up in the morning and looking at the alarm clock with your naked eyes. You then grab your smart phone to check your email and the latest status updates from your friends on Facebook. While eating breakfast you skim through the newspaper. Continuing the trend, you drive with no glasses to work and then go on to play golf. After playing the best golf of your life, you get a quick swim in which is a pleasure without glasses or contact. On your way home you pick up groceries without squinting to read labels. Then you cut some organic veggies for a nice dinner. While catching up on bedtime reading, you wonder why you did not get this unbelievable rejuvenating therapy before.
Benefits of Presbyopic Implant in Eye or PIE surgery
PIE procedure treats the ailment known as Presbyopia. Let us understand the meaning of each word in the acronym. The expanded form of PIE is “Presbyopic Implant in Eye”. The term has nothing to do with the mathematical term pi used in mathematical calculations.
Presbyopia is a natural change in the natural lens of the eye that occurs over time and affects one’s ability to see near objects. Generally, around age forty- five, individuals begin to experience this condition and it continues to progress as we age. To correct this condition most people begin to wear reading glasses.
Even those individuals that have undergone Lasik earlier in life feel the need to reach for reading glasses. People who already were wearing glasses would graduate to more cumbersome bifocals or progressives. This condition makes it increasingly difficult to focus on objects near, middle and far. Presbyopia, in the term “Presbyopic Implant in Eye” means that it cures presbyopia.
The implant is a newer, synthetic, biocompatible lens placed in the space of the remaining natural lens after the old contents have been removed. Biocompatible means that the body will tolerate it and not develop any allergies, nor reject the new lens. Presbyopic implants are specialized, groundbreaking lenses developed by optical engineers utilizing the latest techniques of Nano engineering.
The implants allow the eye to see near, middle and far. They are of different shapes and sizes. PIE can be defined as exchanging the contents of an improperly functioning, old natural lens with a newer artificial inert presbyopic implant, which can help us see at all distances and decrease, or even eliminate, dependency on glasses or contact lens.
PIE is the creme de le creme of methods to rejuvenate aging eyes. It is superior to other methods which combat the effects of taking too many revolutions around the sun.
PIE is more advantageous than glasses!
If you didn’t agree with this you would not be reading this page.
- Glasses can get foggy in the rain.
- Swimming with glasses if near impossible.
- Scuba diving is no fun.
- Always forgetting where you kept your glasses.
- Pets like to use them as chew toys.
- Your grand kids might scratch them.
- You can fill in the blank with your own problems with glasses here __________________.
It’s safe to say PIE overcomes all these nuisances.
PIE gives binoucularity which is better than monovision
Monoivision is a process of setting the focus of one eye on close-up objects and the focus for your other eye on far-away objects. In doing this, your brain combines the two images to create a clear picture. This is a relic from the twentieth century. The primary disadvantage with monovision is one looses their binocular vision. PIE allows you to preserve your binocular depth of field vision.
PIE is superior to multifocal contact lenses
Multifocal contacts move with every blink. The image presented to the brain fluctuates, confusing the brain. That is why many people are not able to adapt to multifocal contact lenses. Presbyopic implants are stable and do not move. The brain neuroadapts to the lenses, improving vision. Contacts can lead to sight threatening cornea infections for as long as you wear them. Presbyopic implants are not exposed to the elements or bugs.
Indications: To cure simple presbyopia or presbyopia associated with myopia, hyperopia or astigmatism
Contraindications: Sever macular degeneration, advanced glaucoma with visual field defect and proliferative diabetic retinopathy.
Types of PI or Presbyopic Implants
There are four classes of FDA approved PI. These are Accommodative, Extended Depth of Field (EDOF), Trifocal and Multifocal.
This class of PI were the first to be approved by FDA in 2005. They heralded the advent of PIE. Crystalens was the first out of the stable. It had various modifications until it evolved into Crystalens HD and now we have Crystalens AO and Trulign. They are made of silicone. Crystalens AO has aspheric optics whereas Trulign has aspheric optics and built in astigmatism correction. They work by assuming a curved shape in the eye, increasing the range of focus. This shape and the unique design of the lens may also allow it to move forward and backward, mimicking the natural lens. This lens has proved very useful in patients who have had previous eye surgery like Lasik vision correction, Radial Keratotomy and other corneal procedures.
Extended Depth of Field (EDOF) PI
They are in a class of their own. They resemble multifocal PI in appearance, but function on a different optic principle. They increase the natural depth of field. It provides a continuous field of vision, though the range is not as extreme as in multifocal. Symfony and Symfony Toric are the two contenders here. As you may have guessed from the names, Symphony Toric can also correct astigmatism. Hence, they find great use in eyes with astigmatism. EDOF are used as an alternative to Crystalens in previously operated eyes. They can also be used when trying to replicate a person’s monovision and in amblyopic (lazy) eyes.
They are truly bifocal but were labeled multifocal to distinguish them from bifocal glasses and contact lenses. Their mechanism of action is totally different than bifocal glasses. In bifocal glasses the top segment is for distance and lower for near. These are refractive lenses. This method was tried in implants in the previous century but was not successful.
Multifocal PI can be either refractive or diffractive in construction. The refractive multifocals, like Array, have been discontinued. The diffractive multifocal implants have apodiazations (concentric rings of different heights) which split incoming light. They have a focal length for distance and one for near with an overlap for middle. One does not have to tilt their head to see near. They are best for near and distance vision. Restor and Tecnis are the two lenses in this class.
Currently we have only Panoptix and astigmatism correcting Panoptix Toric. These PI have apodiazations or rings in their center similar to Restor multifocal. Optical engineers can modulate the height of the rings and distance between rings to design varying focal length for each zone. The unique heights of the rings of this lens allow the incoming light to be split into three foci. One for distance, second for intermediate and third for near. This lens is great for people who devote most of their time to computers and intermediate vision, like financial analysts and computer programmers.
A surgeon who is a PIE expert needs to be proficient in all different classes and types of presbyopic implants. Success is truly achieved when the patient’s goals and desires are understood and the best PI for those needs is implanted. Personality, work, hobbies and sports all influence the decision for the final implant chosen. This may even sometimes involve implanting a different class of PI in each eye.
We now have an overview of different varieties of available presbyopia implants.
It is truly a miracle. I had been told multiple times there was no hope for my right eye after an orbital surgery. Dr.Khanna used his magic with Presbyopic Implants and now I see 20/20 or better at all distances.
Detection Analysis: IOL Master or Lenstar bio-metric devices measure the length and shape of the eye. They utilize advanced formulae to help determine the power of the Presbyopic Implant need to get the optimum outcome.
Equipment For Surgery: Recent generation machines like Centurion by Alcon, Stellaris Elite by Bausch & Lomb and Whitestar Signature Pro by Johnson & Johnson are necessary.
Variations in procedure: Toric Presbyopic Implants can treat the existing astigmatism at the same time. Istents, or similar devices, may used to treat mild to moderate glaucoma.
Comparing with other procedures:
Type of Procedure
Zone of Vision
Distance & Middle
& Near Vision
Distance or Middle or Near Vision
Permanently glasses free
Need for glasses by age 45
Corrects Extreme Refractory
Does not cause
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Is PIE possible after Lasik?
PIE can still be performed after a patient has already had Lasik. The accuracy of the implant needed for the procdure requires special calculations. After the PIE procedure the flap may accumulate fluid and delay healing. A small optical zone created by the laser may interfere with the functioning of the implant. Of course, most patients are very happy to have PIE after Lasik. They wore glasses in their youth and Lasik freed them from the glasses. Having to wear glasses again is very frustrating for them.
In summary, PIE is more advantageous than Lasik for people above 45 and surely for those above 55. Thus, PIE has been termed as Lasik++.
Day of Procedure:
After The Operation: