Some people do not enjoy wearing glasses and would prefer to invest in higher cost options in order to increase their chances of achieving this end. Other people prefer not to incur extra out of pocket expenses because they do not mind wearing glasses some or all of the time. Our goal is to provide you with the most current information and options to help you choose which outcome will best fit your needs. Please keep in mind that even the best technology may not eliminate your need for glasses or contact lenses. While we often achieve exceptional results, we cannot guarantee that.
Intraocular Lens Options
During cataract surgery, the natural cloudy lens of the eye is completely removed and replaced with an artificial intraocular lens (IOL). It is important to understand that there is no such thing as a perfect IOL that is the ideal choice for everyone. Some patients are not good candidates for certain technologies based on their anatomy or their preexisting ocular conditions.
While cataract surgery replaces your cloudy lens with a crystal clear one, it is important to realize that the lens is only one component of your visual system. Your overall vision will only be as clear as the weakest component in your visual system will allow. No intraocular lens can correct for previous damage or anomalies to the eye caused by certain eye conditions, disease, or injury.
Your surgical counselor and surgeon will discuss the options with you to help you make a decision that will best fit your goals and needs.
The standard IOL selected by the majority of patients is called a monofocal intraocular lens. As the name “mono” suggests, these IOLs are designed to improve visual clarity and quality at one single distance (either far, intermediate, or near.) People who select this option should plan on needing glasses or contact lenses to supplement their vision at the other distances.
Monofocal IOLs are included in the charges we submit to your medical insurance. There are typically no additional out-of-pocket costs associated with these lenses.
As we age, the lens inside of our eye gradually loses the ability to focus on near objects. This condition, known as presbyopia, becomes noticeable for most people in their early to mid-40s
Monovision is an option that utilizes the standard monofocal IOL in such a way to decrease your dependence on glasses. With monovision, one eye is corrected fully for distance viewing, while the other eye is purposefully left slightly nearsighted. For most people, the brain will adapt to this arrangement, allowing them to see distance, intermediate, and even some near objects without the need for glasses.
The following are a few points that are important to realize with regards to monovision:
- • Monovision is a tradeoff. Some clarity and depth perception are sacrificed in order to obtain a wider range of vision.
- • Monovision is not for everyone. Some people are unable to adapt to the separation of focus between the two eyes.
- • Patients who have already tried and adapted to monovision with contact lenses are generally excellent monovision candidates.
- • People who have not tried monovision before but are considering it with cataract surgery should try monovision with contact lenses first. Your ophthalmologist can assist you with this as part of the pre-operative evaluation.
• While monovision reduces your dependence on glasses for near tasks such as reading music, scanning a menu or article, or viewing the computer screen, it may not work as well for reading fine print or reading for a prolonged period of time and mild reading glasses may still be required at times.
Premium IOLs are designed to minimize, and possibly eliminate, your need for glasses and contact lenses following cataract surgery. Premium lenses include Multifocal IOLs and Toric IOLs. Currently, these lenses are not billable to medical or vision insurance, which means there is an additional out-of-pocket expense paid for by the patient. Not everyone is a candidate for these lenses. Your surgeon can help you determine which technologies are best for you.
Multifocal or Presbyopia-Correcting IOLs
Presbyopia occurs when the lens of the eye is no longer able to change focus. A multifocal (or presbyopia-correcting) IOL makes it possible to focus at distance, intermediate, and near with the same eye. This option minimizes the need for bifocal glasses, contact lenses, or reading glasses after surgery. While multifocal IOLs give you the best chance for independence from glasses or contact lenses after your surgery, due to individual variations in anatomy, this cannot be guaranteed. Some people may still require glasses with their multifocal IOLs to fine tune their vision.
Astigmatism occurs when the eye is more curved in one direction than another and degrades vision at all distances. This condition is unrelated to cataracts. Astigmatism can be in the lens (lenticular astigmatism) or in the cornea (corneal astigmatism). Lenticular astigmatism is simply corrected by removing the cataract. If you have corneal astigmatism, this will persist after surgery unless something is done at the time of surgery to correct it. A Toric IOL can be implanted during cataract surgery to correct for the corneal astigmatism.
Some people who want to be able to see at all distances with the aid of a multifocal IOL also have astigmatism. Fortunately, multifocal IOLs come in astigmatism-correcting varieties as well, called a Toric Multifocal IOL.
Laser Cataract Surgery (LenSx®)
The LenSx® laser is an advanced computer-controlled laser that creates incisions to enter the eye and to reduce astigmatism and also aids in fragmenting the cataract without the use of blades. LenSx® can be used in conjunction with any of the previously discussed IOL options (standard monofocal lens, multifocal lens, or toric lens).
For standard cataract surgeries, studies have shown there is no significant difference in visual outcomes or safety when using the laser compared to standard cataract removal techniques. LenSx® is not currently billable to medical or vision insurance.