Special Intraocular Lenses

Special Intraocular Lenses

In our lens clinic, we provide advice on the various options for lens implantation. As we cover the full surgical spectrum, we are extremely well placed to optimally address your specific needs. Intraocular lenses (IOLs) have been our main focus for many years. We are involved in various clinical evaluations and present our results at international conferences. Thus, we have many years of experience and we can offer you the latest technology and the best possible option for your eye.


Intraocular lenses come in the following types:


Monofocal Lenses:
Monofocal lenses are usually used in cataract surgery. The operation (phacoemulsification = removal of the cloudy, grey, white lens) and insertion of this clear synthetic lens brings about a significant improvement in vision (colors, contrasts). These lenses (monofocal = one focus) enable sharp vision at a specific distance that depends on the IOL calculation. They are usually set up for clear distance vision, which means that you need reading glasses for intermediate and near vision.


Aspherical Lenses:
These lenses are able to additionally improve contrast vision in twilight and at night and reduce glare, giving you still better image quality, even in poor light.


Toric Lenses:
Astigmatism (= abnormal curvature of the cornea) may be corrected with toric intraocular lenses. They enable clear distance vision and near vision for patients with astigmatism.


Multifocal and Trifocal Lenses:
Multifocal / trifocal / diffractive lenses increase the range of vision without glasses, because they can focus on both near and far distance. This means it is possible to have glasses-free distance vision and also do close work without glasses. Thus, you can manage 80-90% of the day without glasses. These lenses are most suitable for patients, who are so keen to have minimal reliance on glasses that they are willing to accept certain compromises on image quality.


Enhanced Depth of Focus Lenses:
EDOF lenses are a special type of intraocular lenses that offer improved depth of focus. They provide very good distance vision and also clear intermediate vision (PC distance, kitchen countertops, speedometer, etc.). You only need glasses for small print close up. With these lenses, you can reduce or eliminate your dependence on glasses and at the same time cut out irritating phenomena such as glare and reduced contrast.


Magnifying Lenses:
This groundbreaking technology is used the context of magnifying surgery (MAGS) Macular diseases (macula = site of clearest vision on the retina) make reading completely impossible in many cases (macular degeneration – AMD). Inserting a magnifying lens has the effect of magnifying close objects, rather like when you use a magnifying glass. This enhances visual function, which can dramatically improve quality of life, giving those affected more autonomy in their daily lives.

It enables them to carry out everyday activities independently again (eating, drinking, cooking, brushing teeth, personal hygiene, looking at photo albums or making telephone calls).

Another subtype of “AMD lens” attempts to involve healthier areas of the central retina (macula) in focusing, by prismatically bending the beam of light entering the eye. This moves the disturbing dark spot (scotoma) slightly to the side, so that it is not exactly in the center of the field of vision, which makes it less troublesome for the patient with macular disease. With some training it can make it possible to identify letters close up again.

Our surgery, Borkenstein & Borkenstein, was involved in the clinical evaluation of this new technology (MAGS) from the start. The results from a variety of studies are unveiled and presented at international conferences. (Press – Eurotimes Sept.2017)


Lenses with Special Surface Coating:
These lenses have additional coatings on the surface, e.g. a heparin coating. The aim of these coatings is to further reduce the postoperative inflammatory response in patients with certain diseases or degeneration (e.g. some forms of glaucoma, pseudoexfoliation syndrome, inflammation of the iris and diabetes mellitus) for an even better recovery without complications. There are currently several ongoing studies around the world that are discussing this controversial topic.


Yellow Lenses:
The special tint of “blue blocking IOLs”, or yellow lenses, filters out short-wavelength, “high-energy” blue light, which may be implicated in the development of macular degeneration. The aim of these lenses is thus to provide extra protection for the retina. A possible effect on melatonin release and therefore on sleep cycle is also under investigation. This means it is extremely important to weigh up the pros and cons carefully and assess the risk for the individual (any family history of macular degeneration, age at implantation, condition of the macula, etc.). We will be happy to advise you. (Press - Augenspiegel 2008)


Add-on Lenses:
Add-on lenses, or “piggyback lenses”, are a little thinner than posterior chamber lenses, but have a slightly larger diameter. They are placed over a lens that is already in the eye. This can bring further improvements for short sightedness, long sightedness and astigmatism (“residual blurring”). Add-on lenses are an elegant alternative to laser treatment of the cornea, which is always irreversible. The operation to implant an add-on lens is reversible – which means that, in theory, the add-on lens can be removed at a later time.


Special Implants:
Special implants can often be used to produce a subjective improvement in serious diseases of the eye with severe, chronic symptoms. For example, it is possible to effect an improvement in irregular astigmatism and extreme sensitivity to light using “pinhole implants” to produce a stenopeic aperture or to use a black diplopia implant to relieve the symptoms of intractable diplopia (double vision). Following serious penetrating injuries (traumas) involving the iris, aniridia implants can reduce glare and produce cosmetically attractive results. Implantation of capsular tension rings can stabilize a lens that trembles because of a weak supporting structure (phacodonesis). In the very rare cases of symptoms caused by “negative dysphotopsia” (= shadow in the outer temporal field of vision), there is the option to implant a new intraocular lens (Masket ND IOL). The larger diameter and special design bring greater stability, which allows a very good centering of the lens. This posterior chamber lens is also fixed to the anterior capsule (edge of rhexis). For very large eyes (severe myopia = severe short sightedness), there are “big foot IOLs” with larger optical and haptic diameters for good, stable centering in wide capsular bags (custom made IOLs).

We have specialized in intraocular lenses and special implants for many years and we can thus provide several variants. With our clinical experience and participation in international conferences, we are happy to advise you on other new innovations.


Lens Materials:
It is particularly important to select the right lens material. There are distinctions between acrylic lenses, silicone lenses, PMMA lenses, and, depending on the water content and composition, hydrophobic and hydrophilic lenses.

“Glistening” occurs after a time with certain lens materials; this is due to tiny cavities developing in the lens, which reduce contrast sensitivity and create glare, thus causing problems for the patient. It is important to take great care when selecting an IOL. As we have many years of experience on the subject of "glistening" through our collaboration and research work with Professor David J. Apple (USA) and Professor Gerd Auffarth (Heidelberg), we have not been using these risky materials at all for years.


Please note:
Not everything that is technically feasible is right for every eye (every patient)!


Thus, it is not possible to make blanket statements (good or bad). At our practice, the decisions we make are specifically tailored to you and your eye. It is essential that the choice of a special lens or surgical procedure takes your needs into account (work, hobbies, everyday challenges). You will be involved in making the decision after we have carried out a detailed examination and met with you to clarify and explain the details.

We cannot guarantee to end your reliance on glasses 100%. However, with an additional lightweight pair of glasses (distance, near, or varifocal), you can improve visual acuity still more, so that you can see clearly at all distances – so long as the eye is healthy and has no further degeneration (diseases).

Before your surgery, the doctor, who is treating you, will discuss with you, which lens is right for you and the additional costs you will have to bear.

We will carry out a number of preliminary eye examinations and precise measurements of the structures of the eye at our clinic. In many cases, it is essential for a good prognosis to collect data from the eye at several different times.

Once we have the results of the examinations, we believe it is extremely important to discuss with you in detail the best possible option for your eyes and your lifestyle. For example, your work, hobbies or sporting activities may affect your individual needs. These must be taken into account. You will be given more details and information at our practice.



In our lens clinic, we provide advice on the various options for lens implantation. As we cover the full surgical spectrum, we are extremely well placed to optimally address your specific needs. Intraocular lenses (IOLs) have been our main focus for many years. We are involved in various clinical evaluations and present our results at international conferences. Thus, we have many years of experience and we can offer you the latest technology and the best possible option for your eye.


Intraocular lenses come in the following types:


Monofocal Lenses:
Monofocal lenses are usually used in cataract surgery. The operation (phacoemulsification = removal of the cloudy, grey, white lens) and insertion of this clear synthetic lens brings about a significant improvement in vision (colors, contrasts). These lenses (monofocal = one focus) enable sharp vision at a specific distance that depends on the IOL calculation. They are usually set up for clear distance vision, which means that you need reading glasses for intermediate and near vision.



Aspherical Lenses:
These lenses are able to additionally improve contrast vision in twilight and at night and reduce glare, giving you still better image quality, even in poor light.



Toric Lenses:
Astigmatism (= abnormal curvature of the cornea) may be corrected with toric intraocular lenses. They enable clear distance vision and near vision for patients with astigmatism.


Multifocal and Trifocal Lenses:
Multifocal / trifocal / diffractive lenses increase the range of vision without glasses, because they can focus on both near and far distance. This means it is possible to have glasses-free distance vision and also do close work without glasses. Thus, you can manage 80-90% of the day without glasses. These lenses are most suitable for patients, who are so keen to have minimal reliance on glasses that they are willing to accept certain compromises on image quality.


Enhanced Depth of Focus Lenses:
EDOF lenses are a special type of intraocular lenses that offer improved depth of focus. They provide very good distance vision and also clear intermediate vision (PC distance, kitchen countertops, speedometer, etc.). You only need glasses for small print close up. With these lenses, you can reduce or eliminate your dependence on glasses and at the same time cut out irritating phenomena such as glare and reduced contrast.


Magnifying Lenses:
This groundbreaking technology is used the context of magnifying surgery (MAGS) Macular diseases (macula = site of clearest vision on the retina) make reading completely impossible in many cases (macular degeneration – AMD). Inserting a magnifying lens has the effect of magnifying close objects, rather like when you use a magnifying glass. This enhances visual function, which can dramatically improve quality of life, giving those affected more autonomy in their daily lives.

It enables them to carry out everyday activities independently again (eating, drinking, cooking, brushing teeth, personal hygiene, looking at photo albums or making telephone calls).


Another subtype of “AMD lens” attempts to involve healthier areas of the central retina (macula) in focusing, by prismatically bending the beam of light entering the eye. This moves the disturbing dark spot (scotoma) slightly to the side, so that it is not exactly in the center of the field of vision, which makes it less troublesome for the patient with macular disease. With some training it can make it possible to identify letters close up again.

Our surgery, Borkenstein & Borkenstein, was involved in the clinical evaluation of this new technology (MAGS) from the start. The results from a variety of studies are unveiled and presented at international conferences. (Press – Eurotimes Sept.2017)


Lenses with Special Surface Coating:
These lenses have additional coatings on the surface, e.g. a heparin coating. The aim of these coatings is to further reduce the postoperative inflammatory response in patients with certain diseases or degeneration (e.g. some forms of glaucoma, pseudoexfoliation syndrome, inflammation of the iris and diabetes mellitus) for an even better recovery without complications. There are currently several ongoing studies around the world that are discussing this controversial topic.


Yellow Lenses:
The special tint of “blue blocking IOLs”, or yellow lenses, filters out short-wavelength, “high-energy” blue light, which may be implicated in the development of macular degeneration. The aim of these lenses is thus to provide extra protection for the retina. A possible effect on melatonin release and therefore on sleep cycle is also under investigation. This means it is extremely important to weigh up the pros and cons carefully and assess the risk for the individual (any family history of macular degeneration, age at implantation, condition of the macula, etc.). We will be happy to advise you. (Press - Augenspiegel 2008)


Add-on Lenses:
Add-on lenses, or “piggyback lenses”, are a little thinner than posterior chamber lenses, but have a slightly larger diameter. They are placed over a lens that is already in the eye. This can bring further improvements for short sightedness, long sightedness and astigmatism (“residual blurring”). Add-on lenses are an elegant alternative to laser treatment of the cornea, which is always irreversible. The operation to implant an add-on lens is reversible – which means that, in theory, the add-on lens can be removed at a later time.


Special Implants:
Special implants can often be used to produce a subjective improvement in serious diseases of the eye with severe, chronic symptoms. For example, it is possible to effect an improvement in irregular astigmatism and extreme sensitivity to light using “pinhole implants” to produce a stenopeic aperture or to use a black diplopia implant to relieve the symptoms of intractable diplopia (double vision). Following serious penetrating injuries (traumas) involving the iris, aniridia implants can reduce glare and produce cosmetically attractive results. Implantation of capsular tension rings can stabilize a lens that trembles because of a weak supporting structure (phacodonesis). In the very rare cases of symptoms caused by “negative dysphotopsia” (= shadow in the outer temporal field of vision), there is the option to implant a new intraocular lens (Masket ND IOL). The larger diameter and special design bring greater stability, which allows a very good centering of the lens. This posterior chamber lens is also fixed to the anterior capsule (edge of rhexis). For very large eyes (severe myopia = severe short sightedness), there are “big foot IOLs” with larger optical and haptic diameters for good, stable centering in wide capsular bags (custom made IOLs).

We have specialized in intraocular lenses and special implants for many years and we can thus provide several variants. With our clinical experience and participation in international conferences, we are happy to advise you on other new innovations.


Lens Materials:
It is particularly important to select the right lens material. There are distinctions between acrylic lenses, silicone lenses, PMMA lenses, and, depending on the water content and composition, hydrophobic and hydrophilic lenses.

“Glistening” occurs after a time with certain lens materials; this is due to tiny cavities developing in the lens, which reduce contrast sensitivity and create glare, thus causing problems for the patient. It is important to take great care when selecting an IOL. As we have many years of experience on the subject of "glistening" through our collaboration and research work with Professor David J. Apple (USA) and Professor Gerd Auffarth (Heidelberg), we have not been using these risky materials at all for years.


Please note:
Not everything that is technically feasible is right for every eye (every patient)!


Thus, it is not possible to make blanket statements (good or bad). At our practice, the decisions we make are specifically tailored to you and your eye. It is essential that the choice of a special lens or surgical procedure takes your needs into account (work, hobbies, everyday challenges). You will be involved in making the decision after we have carried out a detailed examination and met with you to clarify and explain the details.

We cannot guarantee to end your reliance on glasses 100%. However, with an additional lightweight pair of glasses (distance, near, or varifocal), you can improve visual acuity still more, so that you can see clearly at all distances – so long as the eye is healthy and has no further degeneration (diseases).

Before your surgery, the doctor, who is treating you, will discuss with you, which lens is right for you and the additional costs you will have to bear.

We will carry out a number of preliminary eye examinations and precise measurements of the structures of the eye at our clinic. In many cases, it is essential for a good prognosis to collect data from the eye at several different times.

Once we have the results of the examinations, we believe it is extremely important to discuss with you in detail the best possible option for your eyes and your lifestyle. For example, your work, hobbies or sporting activities may affect your individual needs. These must be taken into account. You will be given more details and information at our practice.