A cataract is a medical condition that can only be treated with surgery. You may elect to have cataract surgery once your vision is impaired to the point where you can no longer see comfortably for your daily activities (driving, reading, watching TV, etc.) When cataracts progress to this point, the surgery is covered by medical insurance. The purpose of cataract surgery is to restore clear vision by removing the cloudy natural lens and replacing it with a clear artificial lens. Cataract surgery is not intended to eliminate the need for glasses. However, over the last several years, technology in the field of intraocular lens implants (IOLs) has provided more options for cataract patients who are interested in reducing their need for glasses after cataract surgery. These “Custom IOLs” are not considered medically necessary, but patients have the option to pay for this technology if they desire. Specific testing is required to determine if a patient is a good candidate for any of these IOLs.
Custom IOLs provide an opportunity for patients to achieve not only an improvement in vision, but greater freedom from glasses compared to a standard IOL. The Custom IOLs offered by Eye Associates of New Mexico are listed below.
Astigmatism Correcting IOLs
Patients having cataract surgery who also have astigmatism (a condition causing blurred vision where the cornea is more oval shaped than round) now have the option of having their astigmatism corrected with the IOL at the time of cataract surgery. These are referred to as “Toric IOLs” and they are a modification of the standard, single-focus IOL’s used in cataract surgery. These IOL’s have astigmatism correction built into the lens itself, and are positioned inside the eye in order to reduce or eliminate the patient’s astigmatism. These IOLs are very successful in correcting astigmatism and can reduce the dependency on glasses more than the standard IOL can provide.
Unlike standard monofocal or single focus IOLs, the multifocal IOL provides both a near and distance focus. This lens is designed to distribute light energy entering the eye, focusing the vision for distance and near. The multifocal IOLs have a variety of different models to suit a patient’s preferences. The near focal point of the multifocal can be selected for very close range, normal reading vision distance, or computer/intermediate distance. By customizing the near vision, the IOLs have the potential to greatly reduce the dependence on glasses after cataract surgery.
Some patients with a multifocal IOL may notice rings or halos around light when driving at night, but over time this problem tends to lessen or go away completely as the eye and the brain adapt to the lens.
Extended-Depth of Focus IOLs
An extended-depth of focus IOL is designed to enable a range of uncorrected vision from distance to the intermediate zone. Unlike a multifocal IOL which has two distinct focal points (a distance and a near focus), the extended-depth of focus IOL is designed to provide a more continuous range of vision from distance to intermediate. It essentially expands the depth of focus compared to what the standard IOL can provide. Patients should expect to wear glasses for reading and close work.
Because of the IOL design, some patients with the extended-depth of focus IOL may notice glare and halos at night, but these symptoms can lessen over time.
Custom IOLs are not ideal for all patients, so patients should talk to their surgeon about these options and discuss which IOL will work best for their lifestyle.
One other option available for focusing at more than one distance involves something called Monovision. This technique has long been used by some contact lens wearers to focus one eye for distance and one eye for near. This same effect can be achieved with cataract surgery using Standard or Toric lens implants. Monovision requires extra testing and planning before surgery, but does help patients achieve greater freedom from glasses after cataract surgery.