Cataract surgery is one of the most successful operations in all of medicine. An intraocular lens is a replacement lens placed in the eye during surgery and is a permanent solution to help improve your current vision. These devices are made of special plastics and implanted within the eye after the cataract is removed to help focus light images. Monofocal intraocular lenses focus the image only at one single focal point. In the late 90’s, intraocular lens companies began to develop lenses that would help focus near, intermediate and distance. These intraocular lenses allow a patient to be less dependent on glasses. Together your surgeon and you will discuss the best lens option to fit your lifestyle and vision goals.
Different lenses perform better under different lighting conditions.
A standard lens has the same curvature all over the surface and is called a spherical lens. Light that hits the lens on the periphery (toward the edge) will be refracted (bent) stronger than the light that hits the center of the lens, focusing the light on more than one focal point. This is what can cause vision to be blurred. This lens provides clear vision at a single, fixed focal point. This means the surgeon can calculate the lens power needed to help improve a patient’s vision at either distance or near. Many patients prefer the distance correction especially if they enjoy activities requiring good far away vision, such as driving, watching television or sports. Reading glasses are needed with this option. Other patients may desire to have the IOL power calculated to help them with near activities such as reading, or using the computer. In such cases, glasses for distance activities will be required. A standard monofocal lens can be designed with a micro-prescription in only 0.50 diopter increments.
For vision to be sharp and clear, all the light has to focus onto one focal point. The curvature of the periphery of the lens has to decrease while the central curvature remains the same. This non-spherical intraocular lens can mimic your natural lens and is called an aspheric lens.
The Softec® HD lens has a patented aspheric design on both the front and back surfaces, which is designed to provide crisper and sharper vision. This lens can help improve the quality of vision in all lighting conditions. Unlike a spherical monofocal lens, the Softec® HD lens has micro-prescription optics of 0.25 diopter increments. A comparison would be if your shoes came in ¼ opposed to only ½ sizes, your shoes would fit better. The same is true for your intraocular lens implant - the fit is better. Your surgeon will be able to closely match a lens with your intraocular lens prescription, which will best meet your needs and give you the best visual outcome.
The Crystalens® is the only accommodative lens approved by the FDA and is intended to provide a continuous range of vision including distance, intermediate, and near. It is designed to mimic the eye’s natural process of accommodation and helps to lessen the dependence on corrective lenses. The Crystalens® is engineered with a hinge, designed to allow the optic to move with the eye and thus, changing the focal point. The ciliary muscle is located within the eye and will work to move the Crystalens® optic forward to adjust for mid-range and near vision. When this muscle relaxes, the lens moves backward to focus on distant objects. The Crystalens® requires a visual rehabilitation program that patients must perform to help the ciliary muscle regain the far to near focusing power. While your distance vision is usually good shortly after surgery, the intermediate and near vision will require the visual training. This program will begin after the first week of surgery and continue for up to six months. Near vision often continues to improve up to a year after surgery.
A multifocal intra-ocular lens is designed to provide quality near, intermediate and distance vision by combining the strengths of optical principals used in microscopes and telescopes. The multifocal IOL works by a series of tiny rings working together to focus light for both near and distance vision.
For most patients, a multifocal IOL delivers excellent near and distance vision with good intermediate vision thus reducing the need for glasses. Clinical trials have shown that there is also a chance of halos or rings around light that may occur. Over time, most patients grow accustomed to this and cease to notice them while a small percentage can continue to see them long after surgery.
Astigmatism is a common optical condition that occurs when the shape of the cornea is more oval than round. This causes blurred or distorted vision, glare and ocular fatigue. The oval shape causes light rays to focus on two points in the back of your eye, rather than just one. For patients with existing corneal astigmatism, the AcrySof® Toric intraocular lens implants can give patients quality vision with less dependence on their glasses. This IOL is placed in the eye at a precise location in order to reduce or eliminate corneal astigmatism and significantly improve distance vision and lessen the dependence on glasses. Patients with a toric IOL usually wear glasses for tasks such as reading or working on the computer.
While the latest technology in intraocular lenses offer an attractive benefit to our patients, these IOL’s are outside the standard coverage of Medicare and third-party payers. This means patients who desire an upgrade from a standard monofocal IOL will be required to pay additional charges beyond those associated with standard cataract surgery. These fees will be explained in full detail and you will be asked to sign an Advance Beneficiary Notice (ABN) before proceeding with surgery.