# Are You a Smart Lens Candidate? Find Out in 5 Questions **Kaskaloglu Eye Hospital | Izmir** --- "Can I have smart lens surgery?" — Anyone asking this question is actually asking several things at once: Is my age right? Are my eyes suitable? Will my health history be a problem? What results can I realistically expect? In this article we will address each of these questions in turn. Work through the five questions below honestly. You will have a clearer picture of where you stand before your appointment — and be able to have a far more productive conversation with your surgeon. > **Important note:** This article is for general information only. A definitive candidacy assessment can only be made through a comprehensive eye examination. The questions below are a starting point — not a diagnostic tool. --- ## Question 1: How Old Are You? **If you are 40 or over, you are in the most natural candidate group for smart lens surgery.** From around age 40–45, the eye's natural crystalline lens gradually loses its flexibility. This is called **presbyopia** — the progressive difficulty in focusing on near objects that leads to reading glasses, holding your phone further away, or struggling to read in dim light. Smart lenses (trifocal and EDOF) replace this natural lens entirely. They are designed to restore clear vision at multiple distances, and they are most effective in the **45–70 age range**, where presbyopia is well established. **If you are under 40:** Smart lens surgery is not usually the recommended route. Laser vision correction (LASIK or SMILE Pro) is typically preferred for younger patients. Some exceptions apply — particularly for patients with high prescriptions or corneas unsuitable for laser treatment — but in these cases a different type of intraocular lens (phakic lens / ICL) is generally considered rather than a premium multifocal. --- ## Question 2: What Vision Problems Do You Have? Smart lenses are particularly compelling for patients with more than one vision issue, because a single procedure can address several problems simultaneously. **Smart lens surgery is likely a strong option if:** - You have **both distance and near vision problems** — myopia or hyperopia alongside presbyopia - You have **astigmatism** — both trifocal and EDOF lenses come in toric versions that correct astigmatism at the same time - You have **early or developing cataracts** — smart lenses can be implanted during cataract surgery, correcting your vision problem and removing the cataract in one operation - You have a **high prescription** and your corneas are too thin for laser correction — lens-based surgery bypasses the cornea entirely **Situations where other options may be more appropriate:** - You have only a very low prescription — laser treatment may be simpler and equally effective - Your prescription is still changing — most surgeons prefer to wait until it has been stable for at least one to two years - You are under 40 without significant presbyopia — the advantages of a premium multifocal lens are considerably reduced without presbyopia --- ## Question 3: How Is Your General Health? Smart lens surgery is performed under local anaesthetic eye drops in around 8–10 minutes per eye. General anaesthesia is not required. Nevertheless, certain health conditions are worth discussing with your surgeon. **Well-controlled chronic conditions are generally not a barrier.** Many of our patients with treated hypertension, thyroid conditions, or stable cardiac conditions undergo surgery successfully. What matters is that your conditions are monitored and under control. **Conditions that require more careful assessment include:** - **Poorly controlled diabetes:** High blood glucose impairs healing and increases infection risk. If you are diabetic, your HbA1c level will be considered as part of your pre-operative assessment. - **Autoimmune conditions:** Rheumatoid arthritis, lupus, Sjögren's syndrome, and similar conditions can affect the ocular surface and healing process. These are not automatic disqualifications, but they require individual evaluation. - **Immunosuppressive medication:** Patients taking immunosuppressants for any reason need individual assessment. - **Active eye infection or inflammation:** Any active infection or inflammatory episode affecting the eye must be resolved before surgery can be planned. --- ## Question 4: Is Your Eye Structure Suitable? This is the question that only an examination can answer definitively — but knowing what is assessed helps you understand the process. **Corneal health:** Unlike laser surgery, smart lens implantation does not operate on the cornea. The natural lens inside the eye is removed and replaced, which means corneal thickness — so critical for LASIK — is not a direct barrier for lens surgery. However, overall corneal health and surface quality are assessed as part of evaluating the eye as a whole. **Keratoconus:** If you have keratoconus (a condition causing progressive corneal thinning and irregular curvature), premium multifocal lenses may not be appropriate. The optical irregularity of a keratoconic eye can significantly reduce the performance of trifocal or EDOF optics. **Intraocular pressure:** Elevated eye pressure is the key indicator of glaucoma. Patients with known glaucoma or ocular hypertension are assessed individually. Stable, well-controlled glaucoma is not necessarily a barrier — but your surgeon must be aware of it and factor it into the plan. **Retinal health:** Conditions affecting the macula — macular degeneration, diabetic maculopathy — require careful evaluation before premium lens implantation. In some retinal conditions, a standard monofocal lens may deliver better outcomes than a premium multifocal. **Dry eye syndrome:** Mild to moderate dry eye is common and manageable. It does not typically prevent surgery but does need to be addressed beforehand. Severe dry eye is treated and stabilised first; surgery proceeds once the ocular surface is healthy. **Previous eye surgery:** Patients who have had prior laser vision correction (LASIK, PRK, SMILE) can often still have smart lens surgery, but the previous surgery affects certain measurements and calculations. Our diagnostic equipment — including Pentacam HR and iTrace — is used to ensure accurate planning in these cases. --- ## Question 5: Are Your Expectations Realistic? This may not seem like a clinical question, but it is one of the most important. Smart lenses produce excellent results in the right patients. The majority of patients leave surgery living glasses-free or nearly glasses-free. But "glasses-free" has a specific meaning — and aligning your expectations with reality leads to a far more satisfying outcome. **Realistic expectations:** - Most patients drive, work, socialise, and manage daily life entirely without glasses - Some patients — particularly with EDOF lenses — may occasionally use a low-strength reading glass for very fine print or low-light close work - In the first weeks to months after surgery, some patients notice halos or glare around lights at night; this typically improves as the brain adapts (neuroadaptation) - Results vary between individuals — the same lens in two different patients can produce slightly different outcomes **Signs that expectations may need calibration:** - Expecting absolute glasses independence under every possible condition - Very high intolerance for any adaptation period, including temporary night halos - Making the decision under pressure from others rather than from personal conviction These points are not meant to discourage you — they are meant to ensure you arrive at your consultation with a clear picture of what you are choosing and why. --- ## In Summary: Who Is a Strong Candidate? You are likely a strong candidate if you: - Are in the **40–70 age range** - Have **presbyopia** alongside other refractive errors (myopia, hyperopia, astigmatism) - Are in **good general health**, or have chronic conditions that are monitored and controlled - Have **no known significant retinal disease** or keratoconus - Have **realistic expectations** and are making the decision for yourself You may need further discussion before proceeding if you: - Have **diabetes** but are unsure of your current HbA1c level - Have a **history of glaucoma** or elevated eye pressure - Have had **previous eye surgery** of any kind - Experience significant **dry eye symptoms** --- ## What Happens If You Are Not a Suitable Candidate? If your examination reveals that smart lens surgery is not the right option for you, we will tell you clearly and explain why. In some cases, a temporary condition (such as active dry eye) can be treated first, after which surgery can be reconsidered. In other cases, a structural finding may mean that a different approach is more appropriate. An honest answer before surgery is the most valuable thing we can offer you. **[Book an appointment →](https://www.kaskaloglu.com/en/contact/)** --- *Kaskaloglu Eye Hospital is the first dedicated eye hospital in the Aegean region of Turkey. Smart lens pre-operative screening uses Pentacam HR, iTrace, and comprehensive biometry to ensure every patient is assessed to the highest clinical standard.*
