Cataract surgery involves removing the lens in the eye that has become cloudy or hazy. After the natural lens is removed, an intraocular lens is placed inside the eye to restore a person’s vision. The surgery takes only a few minutes to perform and is highly successful. In most cases they are no patches applied to the eye, no shots to anesthetize the eye, and no stitches.
The first intraocular lenses used in cataract surgery occurred in the 1940s in England. Since that time there have been many changes in the design of the lenses. In the last several years lenses have advanced to where they can correct different refractive errors in a patient’s vision such as myopia, hyperopia, astigmatism, and presbyopia. Many of these new lenses that correct a person’s vision are commonly called premium intraocular lenses. These intraocular lenses are not covered by Medicare or insurance as they consider it cosmetic as a person is choosing a more expensive lens to be glasses free or less dependent on wearing glasses after cataract surgery. They still cover the regular cost of the surgery. They don’t cover the cost of the premium intraocular lenses which are more expensive.
Astigmatism or Toric Intraocular Lenses
AcrySof toric IOL (Alcon)
Staar surgical toric IOL (Staar)
Trulign toric IOL (Bausch and Lomb)
Presbyopic Intraocular Lenses
Multifocal Intraocular Lenses
ReZoom IOL (Abbott Medical Optics)
Accomodating Intraocular Lenses
Crystalens (Bausch and Lomb)
Trulign (Bausch and Lomb)
Vision After Cataract Surgery
Patients now have the choice of choosing how they see after cataract surgery. If you have a significant amount of astigmatism, there are intraocular lenses that can correct your vision. This can result is good distance vision without glasses. There are also premium intraocular lenses that correct distance and reading vision. You can now choose how you see after cataract surgery.
Patient with Astigmatism
If you have significant astigmatism and wish to see well at distance without glasses, toric intraocular lenses work very well. Other than good pre-op testing, there are not any other requirements for choosing a toric IOL.
Patients Who Wish to See Distance and Near Without Glasses
Other than the pros and cons of the different lenses, there is not as much concern on the status of the eye as with multifocal lenses.
Multifocal Intraocular Lenses
Multifocal intraocular lenses are special lenses that contain a bifocal like component to the lens. This allows the eye to see at distance and near without glasses. These lenses do not provide good vision in people who have other eye diseases which can interfere with the quality of their vision. You may not be a good candidate for these lenses if you have any of the following conditions (not a complete list)
Corneal diseases i.e. Fuchs dystrophy, significant dry eyes, significant corneal wave front aberrations, and other corneal diseases
Macular Diseases i.e. macular degeneration, macular pucker, and others
Large Angle Kappa
If a person does not have a healthy eye free from corneal and retinal disease they are probably not a candidate for multifocal lenses. In order to see well with these lenses , you need a healthy eye.
Everyone has some aberrations in their vision even if they see 20/20 without glasses. Our eyes are not made perfect and the amount of aberrations can be measured by special equipment in the office. If a person has significant corneal aberrations in their eye, it will decrease the quality of the vision with multifocal lenses.
The angle kappa can also be measured in the office. It is the angle between the center of the pupil and the actual visual axis. People do not necessarily look through the center of their pupil. If a person has a large angle kappa and has a multifocal lens they can have increased aberrations in their vision.
If you wish to be able to see distance and near without glasses there are options available. Multifocal lenses do work very well but you need to make sure that you are a good candidate. It is important to make sure that you don’t have any ocular condition that may keep you from seeing well with multifocal intraocular lenses. A thorough eye exam is necessary. It is wise to also have your vision system evaluated to determine the amount of corneal aberrations present and the amount of angle kappa.