The ZEISS AT ELANA trifocal lens

Why we recommend this lens at OKUMED

Cataract surgery today is more than the removal of a cloudy natural lens. It is the moment when we can consciously choose how you will see for the decades to come — only at distance, or also on the computer screen, at the desk and while reading a book, without reaching for glasses. This is decided by the type of intraocular lens (IOL) we implant in place of the natural one.

Among the many trifocal lenses available today, at OKUMED we propose AT ELANA® 841P by Carl Zeiss Meditec as our first recommendation for carefully selected patients. Below we explain why.

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What a trifocal lens is

The natural lens of a young eye can “refocus” the image depending on distance — this is why we can read without glasses. With age this ability (called accommodation) disappears. After cataract surgery we implant an artificial intraocular lens into the lens capsule, and this lens has no such flexibility of its own.

A trifocal lens solves this by splitting light into three focal points at once — for far, for intermediate distance (computer, car dashboard) and for near (book, phone). Over time the brain learns to choose the right focus depending on what we are looking at.

AT ELANA® 841P is a modern trifocal lens introduced by ZEISS in 2023 as the company’s first fully hydrophobic trifocal lens — the earlier ones (the AT LISA® tri line) were made of hydrophilic acrylic.

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Why we recommend AT ELANA® 841P

1. Exceptionally much light for near — 35%

Every trifocal lens has to “divide” the incoming light between three focal points. ELANA allocates 35% of the energy to near — considerably more than most competing lenses (typically 25%). In practice this means comfortable reading of small print at around 40 cm without additional correction.

For people who read a lot — paper books, smartphones, patient charts — this is often the most important difference between lenses.

2. SMP technology — less light scatter

Trifocal lenses split light thanks to microscopic diffractive rings on the lens surface. In classic designs the rings have sharp edges at which some photons are scattered — the patient may notice this in the evening as halos around car headlights or flashes (so-called glare).

ZEISS developed SMP (Smooth Micro Phase) technology — the rings have smoothed, rounded edges from the manufacturing stage. The effect: less scattered light, gentler adaptation after surgery and fewer night-time complaints, particularly important for people who drive after dark.

3. A high Abbe number (Vd = 51) — better contrast

The Abbe number describes how well the lens material handles light dispersion — the splitting of colours, which degrades image contrast. The higher the Abbe number, the sharper the image, especially in dimmer light and for fine detail.

AT ELANA has Abbe Vd = 51 — a value considerably higher than in many competing trifocal lenses. Clinically this translates into clearer letters when reading in the evening, sharper contours in mesopic conditions (dusk, a candle-lit restaurant) and better quality of vision for patients with high demands — surgeons, architects, graphic designers.

4. Glistening-free hydrophobic acrylic — durability for years

ELANA is made of new-generation, fully hydrophobic acrylic that does not form microvacuoles inside the lens material (so-called glistenings). This phenomenon, known from older designs, could slightly degrade the quality of vision over the years. ELANA’s design eliminates it.

In addition, the hydrophobic material reduces the risk of secondary cataract (PCO, posterior capsule opacification) — the most common late complication after surgery, which requires a YAG laser capsulotomy. In patients with ELANA the rate of PCO is lower.

5. Safety of the YAG capsulotomy procedure

If, despite everything, a laser capsulotomy becomes necessary after years, ELANA’s design is favourable in this respect. The diffractive structure is placed on the front surface of the lens, while the laser acts on the posterior capsule. This means no risk of damaging the diffractive rings during the YAG procedure, which further increases long-term safety.

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What the clinical studies confirm

The decision to recommend ELANA at OKUMED is not based only on the manufacturer’s materials. It is supported by the results of independent clinical studies:

• Janeková et al. (2025) — a multicentre observational study of 252 eyes (126 patients): 84.9% of patients achieved a refractive result within ±0.5 dioptres of the target, with no severe dysphotopsia complications (halos, flashes).
• Fernández-Vega-Cueto et al. (2026, European Journal of Ophthalmology) — a study of 80 eyes: 91% of patients within ±0.5 D, excellent visual acuity results at all distances, 85% of patients with no visual disturbances after surgery.
• Mendicute et al. (2025) — 100% satisfaction on the Catquest 9SF questionnaire in the patients studied.
• Łabuz et al. (2023) — an optical analysis confirming the stability of vision even with small shifts of the lens within the capsule.

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Who AT ELANA is a good choice for

ELANA works best in patients who:

• want real independence from glasses in everyday life;
• have a healthy retina (no macular degeneration, no epiretinal membrane);
• have a stable tear film and a healthy ocular surface;
• have a regular cornea with low higher-order aberrations;
• have low to moderate astigmatism (up to 0.75 dioptres for the version without toric correction);
• have realistic expectations — they understand that even the best trifocal lens is a design compromise.

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Who ELANA is NOT the best choice for

We are also honest about when we propose other solutions:

• patients after corneal refractive surgery such as myopic LASIK — here we consider an EDOF lens (e.g. AT LARA);
• patients with keratoconus, corneal scarring or advanced dry-eye keratopathy;
• patients with macular disease, an epiretinal membrane or advanced glaucoma;
• professional night drivers — particularly sensitive to even minimal dysphotopsia;
• people with unrealistic expectations of the result (“I want to see like I did at 20”).

The decision is always made after a qualification visit with full biometry, corneal topography, fundus assessment and a conversation about lifestyle.

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What to expect after surgery

Most patients after bilateral ELANA implantation:

• read books, newspapers and smartphones without glasses;
• work at the computer and desk in full comfort;
• drive in daylight with good acuity;
• at night may see faint halos around bright lights — in most people these fade or stop being bothersome after a few weeks.

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Qualification at OKUMED

Every decision about the choice of intraocular lens starts with a qualification consultation, during which we perform:

• precise biometry,
• corneal topography and aberration analysis,
• assessment of the ocular surface and tear film,
• a fundus examination,
• a detailed conversation about your everyday visual needs.

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We invite you to book a qualification consultation at OKUMED Gdynia.

Świętojańska 135/2, 81-404 Gdynia, Poland · +48 882 650 299

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This article is for information only. Every case requires an individual medical assessment. The choice of intraocular lens depends on the condition of the eye and the patient’s preferences. Lens implantation, like any operation, carries a risk of complications, which we discuss during the qualification visit.