Binovision A new Approach for Seeing without Glasses · 2020. 3. 26. · 5 m 100 cm 50 cm 33 cm 25...

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Binovision A new Approach for Seeing without Glasses Sylvia Paulig MD WOC Abu Dhabi 2012 · Sylvia Paulig MD Paulig Eye Surgery Centre | Office · Berlin/Cottbus

Transcript of Binovision A new Approach for Seeing without Glasses · 2020. 3. 26. · 5 m 100 cm 50 cm 33 cm 25...

  • Binovision – A new

    Approach for Seeing

    without Glasses

    Sylvia Paulig MD

    WOC Abu Dhabi 2012 · Sylvia Paulig MD

    Paulig Eye Surgery Centre | Office · Berlin/Cottbus

  • Why did I need the

    Light Adjustable Lens?

    WOC Abu Dhabi 2012 · Sylvia Paulig MD

    Paulig Eye Surgery Centre | Office · Berlin/Cottbus

  • 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

    WOC Abu Dhabi 2012 · Sylvia Paulig MD

    Paulig Eye Surgery Centre | Office · Berlin/Cottbus

  • • a correction of astigmatism up to 2.00 D

    • a correction of residual refractive errors

    of up to +/- 2.00 D spherical

    post-operatively.

    The Light Adjustable

    Lens allows

    WOC Abu Dhabi 2012 · Sylvia Paulig MD

    Paulig Eye Surgery Centre | Office · Berlin/Cottbus

  • From October 2008 until Jan. 2012,

    I have implanted the Light Adjustable

    Lens into 183 eyes

    28.2.2009 Dr. med. Sylvia Paulig AugenPraxisKlinik Cottbus

    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).

    WOC Abu Dhabi 2012 · Sylvia Paulig MD

    Paulig Eye Surgery Centre | Office · Berlin/Cottbus

  • In the 93 eyes adjusted for distant vision,

    almost all eyes (86 out of 93), had an UCVA

    of 20/20 or better…

    Adjustment of Distant Vision (uncorrected)

    WOC Abu Dhabi 2012 · Sylvia Paulig MD

    Paulig Eye Surgery Centre | Office · Berlin/Cottbus

  • Distant Vision versus Near Vision (uncorrected )

    0,9–1,3

    20/20–20/16

    0,8

    = 20/25

    ND IV / J 5 ND III / J 4 ND II / J 3 ND I / J 2

    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.

    42

    3

    26

    4

    18

    WOC Abu Dhabi 2012 · Sylvia Paulig MD

    Paulig Eye Surgery Centre | Office · Berlin/Cottbus

  • WOC Abu Dhabi 2012 · Sylvia Paulig MD

    Paulig Eye Surgery Centre | Office · Berlin/Cottbus

    Adjustment of Near Vision (uncorrected)

    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

    ND I / J2

    ND II / J3

    ND III / J4

    ND IV / J5

    ND V / J6

    ND VI / J8

    ND VII / J9

    ND VIII / J10

    …in the 55 eyes adjusted for near

    vision, almost all eyes achieved

    NIEDEN I / JAEGER 2.

  • Near Vision versus Distant Vision (uncorrected)

    0,9–1,3

    20/20–20/16

    0,8

    =20/25

    ND IV / J 5

    ND III / J 4

    ND II / J 3

    ND I / J 2

    0,6

    20/32

    0,4

    20/50

    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.

    24

    1

    17 11

    WOC Abu Dhabi 2012 · Sylvia Paulig MD

    Paulig Eye Surgery Centre | Office · Berlin/Cottbus

    1 1

  • 40–50

    eye

    60

    80

    100

    140

    200

    400

    800

    … and different from MONOVISION,

    my LAL patients had great stereoscopic

    vision. (These are our last 37 patients)

    arc

    seco

    nd

    s

    WOC Abu Dhabi 2012 · Sylvia Paulig MD

    Paulig Eye Surgery Centre | Office · Berlin/Cottbus

    Stereoscopic Vision Titmus-Test

  • The LAL seems to

    create Asphericity

    WOC Abu Dhabi 2012 · Sylvia Paulig MD

    Paulig Eye Surgery Centre | Office · Berlin/Cottbus

  • Defocus Curves

    0

    20

    40

    60

    80

    100

    120

    140

    0 -1 -2 -3 -4 -5 -6

    Vis

    ion

    in

    %

    Diopter Defocus = Vision in distance of x cm

    LAL 1 LAL 2 Multifocal IOL 1 Multifocal IOL 2 Monofocal IOL

    5 m 100 cm 50 cm 33 cm 25 cm 20 cm 16,7 cm

    Vis

    ion

    in

    %

    … 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.

    WOC Abu Dhabi 2012 · Sylvia Paulig MD

    Paulig Eye Surgery Centre | Office · Berlin/Cottbus

  • iTrace demonstrates good Depth

    Perception of Calhoun LAL

    With a large aperture (Iris) a sharp image depends

    on the optimized curvature (asphericity) of the lens.

    Iris Lens Macula

    Large Pupil

    Retinal spot pattern

    Circle of confusion

    (Zerstreukreis) focal area

    which is perceived as

    focussed and clear

    Large depth of field

    WOC Abu Dhabi 2012 · Sylvia Paulig MD

    Paulig Eye Surgery Centre | Office · Berlin/Cottbus

  • Ray Tracing Aberrometry (Tracey

    iTrace) was done before and after

    Light Adjustment.

    WOC Abu Dhabi 2012 · Sylvia Paulig MD

    Paulig Eye Surgery Centre | Office · Berlin/Cottbus

  • Patient 1: prior to 1st adjustment

    WOC Abu Dhabi 2012 · Sylvia Paulig MD

    Paulig Eye Surgery Centre | Office · Berlin/Cottbus

  • Patient 1: after 1st adjustment

    WOC Abu Dhabi 2012 · Sylvia Paulig MD

    Paulig Eye Surgery Centre | Office · Berlin/Cottbus

  • Patient 1: after lock-in

    WOC Abu Dhabi 2012 · Sylvia Paulig MD

    Paulig Eye Surgery Centre | Office · Berlin/Cottbus

  • Patient 2: pre-OP

    WOC Abu Dhabi 2012 · Sylvia Paulig MD

    Paulig Eye Surgery Centre | Office · Berlin/Cottbus

  • Patient 2: prior to 1st adjustment

    WOC Abu Dhabi 2012 · Sylvia Paulig MD

    Paulig Eye Surgery Centre | Office · Berlin/Cottbus

  • Patient 2: after 1st adjustment

    WOC Abu Dhabi 2012 · Sylvia Paulig MD

    Paulig Eye Surgery Centre | Office · Berlin/Cottbus

  • Patient 2: 2 weeks after lock-in

    WOC Abu Dhabi 2012 · Sylvia Paulig MD

    Paulig Eye Surgery Centre | Office · Berlin/Cottbus

  • Patient 3: prior to 1st adjustment

    WOC Abu Dhabi 2012 · Sylvia Paulig MD

    Paulig Eye Surgery Centre | Office · Berlin/Cottbus

  • Patient 3: after 1st adjustment

    WOC Abu Dhabi 2012 · Sylvia Paulig MD

    Paulig Eye Surgery Centre | Office · Berlin/Cottbus

  • Patient 3: 10 days after lock-in

    WOC Abu Dhabi 2012 · Sylvia Paulig MD

    Paulig Eye Surgery Centre | Office · Berlin/Cottbus

  • Patient 4: prior to 1st adjustment

    WOC Abu Dhabi 2012 · Sylvia Paulig MD

    Paulig Eye Surgery Centre | Office · Berlin/Cottbus

  • Patient 4: after 1st adjustment

    WOC Abu Dhabi 2012 · Sylvia Paulig MD

    Paulig Eye Surgery Centre | Office · Berlin/Cottbus

  • Patient 4: 2 weeks after lock-in

    WOC Abu Dhabi 2012 · Sylvia Paulig MD

    Paulig Eye Surgery Centre | Office · Berlin/Cottbus

  • Why BINOVISION?

    28.2.2009 Dr. med. Sylvia Paulig AugenPraxisKlinik Cottbus

    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).

    WOC Abu Dhabi 2012 · Sylvia Paulig MD

    Paulig Eye Surgery Centre | Office · Berlin/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

    WOC Abu Dhabi 2012 · Sylvia Paulig MD

    Paulig Eye Surgery Centre | Office · Berlin/Cottbus

  • 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.

    WOC Abu Dhabi 2012 · Sylvia Paulig MD

    Paulig Eye Surgery Centre | Office · Berlin/Cottbus

  • LAL offers the most valuable

    possibilities for our patients and

    Binovision with the LAL is the

    pink of perfection.

    WOC Abu Dhabi 2012 · Sylvia Paulig MD

    Paulig Eye Surgery Centre | Office · Berlin/Cottbus

  • ___________

    BINOVISION

    The answer we’ve been

    all waiting for.

    Seeing without Glasses

    WOC Abu Dhabi 2012 · Sylvia Paulig MD

    Paulig Eye Surgery Centre | Office · Berlin/Cottbus

  • 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

    WOC Abu Dhabi 2012 · Sylvia Paulig MD

    Paulig Eye Surgery Centre | Office · Berlin/Cottbus