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1 Cataract & Refractive Surgery
Is cataract surgery painful?

Cataract surgery is usually not painful due to the use of anaesthesia.

Can I see anything during the surgery?

It is possible that you will see light and movement.

Will my vision improve immediately after cataract surgery?

You are likely to experience an immediate improvement in your vision however, it might take a few weeks to achieve optimal visual outcomes.

Can the IOL be seen in my eye?

Usually, the IOL can not be seen in your eye.

How succesful is cataract surgery and what about the risks?

While the surgery is considered a safe procedure, the occurrence of complications and adverse events cannot be completely ruled out. However, these adverse events are relatively rare and can be treated successfully.

How does cataract develop?

As people age, the natural crystalline lens of the eye becomes cloudy. The most common cause of cataract is age-related however cataract can also develop due to trauma, the use of certain medications or the presence of certain diseases. Cataract can be present in one or both eyes.

How does it affect your vision?

Cataract can cause blurred vision, problems with glare and faded colours. Difficulties with night vision can also occur. The severity of your cataract depends on multiple factors, including your age and individual health conditions.

2 AddOn Lens
How do I know whether I am a good candidate for the AddOn trifocal?

Your ophthalmologist will make the determination based on an in-depth consultation and detailed eye examination.

What is the implantation procedure like?

The procedure for implanting the 1stQ AddOn® IOL usually takes between 15 and 30 minutes. Similar to cataract surgery it is done in an operating room, but it is a less invasive procedure.

What if I am not happy with the outcome?

Although your vision will improve immediately after the implantation it can take a few weeks or even a few months to achieve the best possible result. Nevertheless, please consult your doctor about any concerns you have after surgery.

Will I still need to wear glasses?

Most patients receiving the AddOn® Trifocal IOL are able to eliminate their need for glasses.2,3 However, individual differences might occur, and the final visual outcome depends on several other ocular conditions.

Will my statutory health insurance cover the cost of the surgery?

Generally, statutory health insurance schemes do not pay for this surgery. Please, contact your health insurance provider directly to find out whether private health insurance would cover the costs.

How can a two-lens system resolve my visual discomfort?

Advanced camera objectives use a group of different lenses to achieve optimal imaging performance. The two-lens system with the AddOn works in a very similar way.

3 Scharioth Macula Lens
How does the SML differ from other lenses?
  • The SML is the only macular lens that can be implanted through a microincision – a tiny 2.2 mm corneal incision. All other AMD lens implants require a larger incision, which might affect post-surgery recovery.
  • Surgery is easy and safe – takes only 15 minutes.
  • Distance vision and the visual field are not impaired after implantation of the SML.
  • The SML is designed for pseudophakic patients – those having an intraocular lens already. Therefore the SML is a secondary lens to be placed in front of a primary intraocular lens. The SML can be implanted simultaneously during cataract surgery, or years later.
I know that such lenses can be extremely expensive, what about the SML?

The SML is less expensive than other AMD implants (in some cases 7–10 times less). The SML is affordable!

Will my macular degeneration will be cured after implantation of the SML?

The SML does not cure AMD. The SML will improve your visual acuity, your ability to read and to see more detail. Remember: After SML implantation you still have to follow the medication and procedures prescribed by your doctor in order to stop or slow down the progression of your AMD. However, the SML will significantly improve your near vision, adding quality to your life.

How can I know that the SML will work in my case?

Talk to your doctor, who has undergone special SML training. They will do the necessary examinations and simulation tests. These tests will show if any improved vision can be reached in your case. After this, you can decide whether the SML is the right choice for you.

Can I do something to decrease the risk of development or stop the progression of AMD?
The development of AMD depends on many factors. If you follow the prescriptions and recommendations you might be able to improve or stabilize your AMD condition:
  • moderate your consumption of alcohol
  • eat a healthy diet with at least five portions of fruit and vegetables a day
  • try to achieve or maintain a healthy weight
  • consider taking vitamin and mineral supplements
  • consult your doctor
The recovery after surgery is usually very quick and most probably you will experience a significant improvement in your reading ability from the first day after surgery. Eventually, you might need a little bit more time to adapt and train your brain to benefit from your newly implanted SML.
Should I follow the special training instructions?

Your doctor will assist you in your rehabilitation, to ‘train your brain’ using the newly implanted SML. BUT DO NOT FORGET: After SML implantation you have to read from a distance of approx. 15 cm!

I am afraid that after I have received an SML implant I will not be eligible for any novel treatment curing AMD, if such will be available in the future.

The SML implantation is fully reversible and does not represent any obstacle to any other treatment that might be chosen later.

4 Liberty Introacular Lens
How does presbyopia develop?

The natural hardening of the crystalline lens happens with age and results in a loss of flexibility, which is needed for lens accommodation (the ability to focus on near objects). Most people begin to notice the symptoms of presbyopia around or after the age of 40.4

How does presbyopia affect your vision?

People with presbyopia find it difficult to see near objects clearly without the use of reading glasses. Headaches and eye strain may also occur. Holding objects further away from the eyes may help with overcoming symptoms during the early stages of presbyopia.

5 References

Knobbe CA. Cataract surgery complications. Available from:


Palomino-Bautista C, Sánchez-Jean R, Carmona Gonzales D, Romero Domínguez M, Castillo Gómez A. Spectacle independence for pseudophakic patients – Experience with a trifocal supplementary add-on intraocular lens. Clin Ophthalmol. 2020; 14:1043–1054.


Harrisberg B. Comparison of refractive and visual outcomes in cataract patients implanted with either premium primary IOLs or with dual implantation approach. Presented in the RANZCO NSW Congress in 2020, Newcastle, NSW, Australia.


Eyeware News: Steady Growth in Cataract Surgical Procedures Is Expected Over the Next 5 Years. Available from:

6 General
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