In this episode of the Eye Views Podcast from Eye News magazine, host Lorcan Butler welcomes Consultant Ophthalmologist Professor Philip Bloom from Western Eye Hospital to discuss the exciting new advances in lens technology and design.Professor Bloom details the shift in cataract surgery goals to, if possible, achieving complete spectacle independence, especially for distance. He explains that this is now achievable in the NHS with the addition of Toric intraocular lenses, enabling many patients to drive without glasses after cataract surgery.The discussion covers the progression in intraocular lens (IOL) options, from monofocal lenses to enhanced monofocal lenses, extended depth of focus (EDOF) lenses, multifocal/trifocal lenses, and the newest continuous range of vision lenses. Professor Bloom shares that while most advanced lenses are in the private sector, enhanced monofocal lenses are increasingly available in many NHS units through the procurement process. He notes that with techniques like mini-monovision, he can confidently offer patients independence from driving and computer glasses, and a lot of independence from reading tasks.A significant portion of the conversation focuses on the challenges and differences between private and NHS practice regarding IOLs. Professor Bloom acknowledges that managed healthcare, even in the private sector, often restricts coverage for the most expensive lenses, leading to patient 'top-ups'. He advocates for allowing top-ups in the NHS to give patients a greater selection of lenses, despite concerns about increased chair time and the management of complications like Toric lens rotation. He stresses the importance of clinicians advocating for their patients.The conversation then pivots to other advancements in the field, including the rise of immediate sequential bilateral cataract surgery (ISBCS), which became more widely adopted post-lockdown as an efficient use of resources to tackle huge backlogs. Professor Bloom also discusses the light adjustable lens (LAL) technology, calling it "extremely interesting", and the ongoing debate between laser and lens-based spectacle independence for pre-presbyopic and presbyopic patients.Finally, Professor Bloom shares his expertise in glaucoma management, focusing on MicroPulse Transcleral Laser Therapy (MP-TLT) and Minimally Invasive Glaucoma Surgery (MIGS). He is a lead investigator for a national registry study on MicroPulse, set up to generate efficacy evidence after a 2021 NICE ruling. He emphasises that the goal of glaucoma surgery, like cataract surgery, is to achieve independence – in this case, from daily eye drops, which can cause significant side effects and inconvenience. He concludes that MIGS has been a "great addition" to patient care.Eye News is the longest-running print and digital magazine dedicated to ophthalmology in the UK, with an international and domestic readership of healthcare professionals, both within the NHS and private healthcare practices. Season 2 of Eye Views is proudly sponsored by Mainline Instruments. Visit their website here: https://eu1.hubs.ly/H0rc4Th0 To reach their team, email: sales@main-line.co.uk
