Premium Lens Implants – Multifocal IOL Vision
Cataract surgery now offers the benefits of improved near, intermediate and distance vision.
If your doctor has informed you that you are a candidate for cataract surgery, you may want to consider enhancing your procedure by selecting a multifocal or accommodating IOL. Unlike standard lenses, multifocal lens design uses technology to provide patients with near, intermediate, and distance vision. Presbyopia is a condition that usually starts to affect people in their early to mid forties when they can no longer see well up close. As a result, presbyopic patients have difficulty with activities such as reading, sewing, and using the computer. In the FDA clinical studies, the majority of patients who received the types of multifocal lenses available at Valley Eye Center reported that they no longer needed glasses for any activities. Many patients note that, after receiving these lenses, reading without glasses is as easy as it was before their forties. Even when patients opt to follow up with a pair of glasses, many find that wearing these glasses is not essential for the majority of their daily functions.
Medicare and most insurance companies cover the cost for cataract surgery using the standard intraocular lens. If you choose to proceed with a multifocal or accommodating IOL, Medicare and most insurance companies will not cover the cost of upgrading your IOL or any additional testing associated with the Premium IOL. Medicare will still provide up to its allowed payment for the standard procedure and operating room time.
Refractive Surgery or Clear Lens Exchange for Candidates without Cataracts
Patients without cataracts may also choose a multifocal lens to correct for farsightedness, nearsightedness, and presbyopia to give them a quality range of vision like they had when they were younger. Presbyopia is a condition that usually starts to affect people in their early to mid forties when they can no longer see well up close. As a result, presbyopic patients have difficulty with activities such as reading, sewing, and using the computer. A procedure called a clear lensectomy, which is similar to cataract surgery, is performed to remove the natural lens and replace it with the multifocal lens. Refractive surgeries are elective procedures and therefore the patient is responsible for all costs. While mulitfocal lenses are designed with the goal of providing independence from glasses and contacts for most activities, they do not guarantee that you will be completely free from needing some correction for certain tasks. Additional refractive adjustments, such as LASIK, may be needed to correct patients to their desired distance results.
Astigmatism, a common eye condition caused by an irregularly shaped cornea or lens, causes distorted or blurred vision. Limbal Relaxing Incisions (LRI) and Toric IOLs are two surgical options designed to correct astigmatism. Before these advancements in technology, patients with astigmatism were required to continue wearing corrective lenses to see more clearly after their cataract surgery. With these surgical techniques, astigmatism patients may now be less dependent on glasses.
Limbal Relaxing Incisions (LRI) and Toric IOLs
Limbal relaxing incisions involve making incisions in the cornea to relax the misshaped cornea, allowing for normal vision to be restored. For cataract patients that are candidates for LRI, your surgeon will do a standard cataract procedure, replacing your cloudy lens with a clear one, and then complete the LRI procedure. Toric IOLs are another option to treat both cataracts and astigmatism. The unique design of the Toric IOLs makes it possible to reduce or eliminate astigmatism and significantly improve uncorrected distance vision while removing the lens clouded by cataracts. These lenses also improve contrast sensitivity in low-light situations, such as driving at night. Toric IOLs are ideal for patients with astigmatism who desire an active lifestyle with reduced need for glasses or contacts.
Because your eyes are so important in everything you do, selecting a premium lens is a very personal decision. At Valley Eye Institute, not only do we want to help you consider all of your options, we want to assist you in deciding on the best lens for you and the lifestyle you desire for the years to come.
Alcon Acrysof Restor® IOL
The Acrysof Restor IOL is currently the most used Multifocal IOL in America. This implant has achieved a high level of success in enabling patient to see clearly at distance and near without spectacle correction. Intermediate vision has been shown to be less than satisfactory in some cases, however the recent introduction of a new model of the Restor lens has been able to provide good vision in all ranges with little or no side effects. The implant is most suitable in patients with minimal or no astigmatism. In patients with clinically significant astigmatism, alternatives such as relaxing incisions in the cornea (astigmatic keratotomy) and LASIK may be used in combination with the Restor IOL to achieve the best possible post-operative result.
As we perform daily activities such as reading, watching television or working at the computer, our eyes are constantly focusing on objects at varying distances – up close, far away and everything in-between. The ability to quickly change focus throughout this range of vision is called accommodation. Unfortunately, this ability diminishes as we grow older, causing us to become dependent on bifocals or reading glasses. However, the AcrySof® ReSTOR® IOL was designed to provide quality near to distance vision.
Anyone who has a normal eye exam and is dependent on reading glasses or bifocals may be a candidate. Although ReSTOR lenses are a breakthrough technology initially approved for cataract patients with or without Presbyopia, it is not necessary to need cataract surgery to qualify for the ReSTOR lens, just a desire to restore eyesight at a range of distances without corrective eyewear.
There are no known contraindications. However, based on the FDA clinical trials, Alcon, the lens manufacturer, has indicated the following types of patients possibly should not have the AcrySof® ReSTOR® Apodized Diffractive IOL:
- People with unrealistic expectations
- People with psychiatric disorders
- People with a history of glare in night vision
Alcon ACRYSOF® Toric lens
Until the recent introduction of Toric IOLs, people who were considered candidates for intraocular lenses could only have their nearsightedness and farsightedness corrected during lens implant surgery. Patients with astigmatism had to either have corneal refractive surgery (LASIK, PRK, or Limbal Relaxation Incisions) after lens implant surgery or remain dependent on glasses or contacts. Now, for patients with cataracts and astigmatism there is the ACRYSOF® Toric lens, which corrects for both conditions simultaneously.
The TECNIS® Multifocal IOL
The newest FDA approved Multifocal Implant is the Tecnis lens manufactured by AMO. This lens has the capability of correcting near and distance vision as well as intermediate. Symptoms such as glare and halo’s have been significantly reduced and quality of vision is excellent. Dr. Stark and Valley Eye Institute were one of only five sites in Ohio to have access to this implant following its initial release.
One of the most important benefits of improved functional vision with the TECNIS® Lens is safety. With compromised functional vision, even patients who have no problem reading the letters on an eye chart can be at a serious disadvantage in low-light situations because they have reduced contrast sensitivity.
The TECNIS® Lens is the only wavefront-designed lens with FDA-approved claims for improved functional vision and improved night-driving simulator performance. Good functional vision is especially important when driving at night. Based on night-driving simulator results in a controlled clinical study, the TECNIS® Lens provided improved visibility that may allow for quicker reaction time, which is likely to provide a meaningful safety benefit to elderly drivers.
The improvement in functional vision may also improve safety in other low-visibility situations.