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