Product Review: Impression ILT (Multifocal by Rodenstock)
For the last few years when we had a difficult prescription or a difficult patient our lens of choice was the Rodenstock Multigressive. In comparison to other multifocals it was streets ahead. We had it reserved as a premium lens and would only consider it if we had a patient with high astigmatism. What an ignorant decision!
We were ignorant because we did not understand how much better this lens was. It was only when one of the Rodenstock reps presented to our practice staff, that we finally understood the unique properties of this technology. A number of assumptions were made in regard to the pantoscopic tilt, vertex distance and face form. The practitioner would supply mono pds etc and the disadvantages of regular multifocals were eliminated by an atoric prescription surface individually optimised for every power combination. This created over one million possible options.
Once we understood what this lens had to offer we gradually increased its usage but it wasn't until the release of the Impression ILT and Impression ILT XS that we were really amazed. Now there were literally an infinite number of possiblities.
What ultimately won me over were two different prescriptions. One was for an unsuccessful keratoconic patient, whose Rx was:
R/ +1.00 -5.00 x65
L/ +4.00 -5.50 x 127
This gentleman had tried multifocals a few times unsuccessully. The distortions were unbearable. I had to talk him into the product, as he was convinced he would fail. He was so amazed that he then came back and bought a second clear pair and a separate pair of multifocal sunglasses.
The other was for my mother-in-law:
R/ plano -1.00 x 80
L/ -0.25 -1.00 x 160
She could not even wear SV distance glasses to walk around with due to the anisekonia induced by the astigmatism being nearly 90 degrees apart between the eyes. I have been having grief with her prescription for over 15 years and here was the first pair of glasses that she could walk around in!
This lens technology requires measurement of:
- Mono PDs - with conventional multifocals most reading aread are decentred 2.5mm. This assumes that every patient converges by 5mm from distance to near. We all no this is incorrect and many of us would fudge the distance PD to make sure the near PD was roughly right.
- Vertex Distance
- Pantoscopic Tilt
- Face Form Angle
These extra measurements even though might seem a nusiance, add tremendous value to the patients perception. The analogy we use is that we are tailor making these spectacles like an expert tailor. We can prescribe and dispense an off the rack product or we can tailor make it specifically for them. When presented in this way, most patients choose the custom made product.
One disadvantage that supressed our usage of this product to begin with was that it takes about 10 days to deliver, as it is manufacturered in Germany. Our perception was wrong though. Most patients felt that was a great delivery time considering the product was being specifically manufacturered for them. Again the tailor made suit analogy helps. Normally when I make a suit I will attend two fittings and the process takes a minimum of 3 weeks, so why should the glasses be any quicker.
Do patients and yourself a favour. Start prescribing this great technology immediately. It is guaranteed to give your practice the edge over the competition. Once your patients have experienced distortion and restriction free vision for the first time they will thank you and never put up with conventional multifocals again.
Apparently Rodenstock are releasing custom made SV lenses and an even better multifocal after ODMA. I find this hard to believe, but the way /this lens has improved over the Multigressive I guess anything is possible.