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    Intraocular Lens Implants (IOLs)

    Modern cataract/lens surgery is safe and effective, capable of rapidly restoring lost vision and allowing a return to an active lifestyle. (Click here to read more about cataracts and cataract surgery.) When a cataract or clear lens is removed, an intraocular lens implant (IOL) is nearly always placed in order to restore vision. IOL technology has advanced significantly since the first lens was implanted in 1949, with improvements in lens materials and designs. Today many IOL choices exist, allowing postoperative vision to be tailored to the individual patient’s needs.

    Standard monofocal IOLs

    The majority of IOLs implanted today are this type. These implants have a single focal length, providing clearest vision at a set distance and requiring glasses for other distances. Most patients elect far distance correction, allowing clear unaided vision for activities such as driving, golf, and even television viewing, but generally requiring eyeglasses for near tasks such as computer viewing or reading. Many people are quite accustomed to this type of vision prior to surgery, as reading glasses become necessary as presbyopia develops after about 40 years of age. If desired, however, IOLs can be implanted to provide good near vision, with glasses worn for distance, as might be desired by someone who has always been myopic (nearsighted). This is ultimately a personal decision, dependent on individual lifestyle considerations.

    Advanced IOL Options

    While most patients are quite happy with the vision provided by standard monofocal IOLs, some are interested in a surgical option that provides good unaided vision at both distance and near. For those looking to minimize dependence on postoperative glasses or contact lenses, a number of options now exist. These are detailed below.

    • Monovision: this describes the use of standard monofocal IOLs in each eye, with one eye focused at distance and the other at near. A disadvantage of monovision is diminished depth perception. Additionally, some are unable to tolerate this arrangement due to the imbalance between the eyes, and surgical monovision is only recommended for those patients who have comfortably and effectively achieved good results with contact lens monovision prior to surgery. For those who have succeeded with contact lens monovision, this is often a very good surgical option.
    • Multifocal IOLs:these lenses allow each eye to focus at both distance and near, somewhat like bifocal or progressive eyeglass lenses. There are presently two main types of multifocal IOLs.
      • Non-accommodating IOLs:like standard monofocal IOLs, these lenses are implanted and remain in a fixed position within the eye. They rely on concentric rings or zones within the optical portion of the implant, allowing light from different distances to be properly focused upon the retina. Today, two such implants have been approved by the FDA for implantation in the United States.
        • Tecnis Multifocal®:Made by Abbott Laboratories, the Tecnis Multifocal implant is a ‘diffractive’ multifocal IOL. A series of concentric ridges on the lens surface serve to focus light from different points, providing good vision at both far and near. Studies indicate that 86% of patients function independently of glasses at all distances at one year, and 99% see 20/40 or better at distance at one year. Glare and halos around lights at night are reported by some patients, and are considered very bothersome by about 5%. There is usually an adjustment period of several weeks to months while your brain learns to function with the implant, with most patients reporting complete comfort with their vision within 6 to 12 weeks. In our experience, near vision with this lens is quite good for computer use and reading normally sized print. The assistance of reading glasses may be required for very small print. Click here to learn more about the Tecnis Multifocal IOL.
        • ReSTOR®:Made by Alcon, the ReSTOR implant is an ‘apodized diffractive’ multifocal IOL. A series of concentric ridges on the lens surface serve to focus light from different points, providing good vision at both far and near. In clinical studies, 80% of patients receiving the ReSTOR IOL reported that they never wear glasses for any activities. 94% said they would have the IOLs implanted again, if given the choice. Glare and halos around lights at night are reported by some patients, and are considered very bothersome by about 5%. There is usually an adjustment period of several weeks to months while your brain learns to function with the implant, with most patients reporting complete comfort with their vision within 6 to 12 weeks. In our experience, near vision with this lens is quite good for reading, including small print. The assistance of glasses may be required for computer use and other tasks at arm’s length. Click here to learn more about the ReSTOR IOL.
    • Accommodating IOLs:Unlike non-accommodating multifocal IOLs, which are fixed in position and utilize zones or rings to achieve their variable focus, true accommodating IOLs shift position slightly within the eye, mimicking the natural ability of the human lens to change focus. There is currently one such IOL approved by the FDA for implantation in the United States.
      • Crystalens®: Made by Bausch & Lomb, the Crystalens IOL is a true accommodating implant. Small flexible hinges within this implant actually allow it to shift forward slightly within the eye when effort is made to change focus. In this manner, the crystalens can provide a range of vision from distance to near, much like the normal human lens. In studies, 98.4% of patients receiving the crystalens were able to read the newspaper or a phone book without glasses, and 100% were able to see computer screens or other objects at arm’s length. 98.4% read 20/40 or better at distance. There is usually an adjustment period of several weeks to months until final visual results are achieved. Unlike non-accommodative multifocal IOLs, this lens design does not commonly cause nighttime glare or halos. In our experience, near vision with this lens is best for computer use and other tasks at arm’s length. Reading glasses may be required for prolonged reading or reading small print. Click here to learn more about the Crystalens IOL.
    Which implant is right for you?

    Choosing an intraocular lens for your cataract surgery or refractive lensectomy may seem a bit overwhelming. In addition to individual visual desires or needs, the overall health of the eye must be considered. In general, multifocal lenses are not recommended for those with significant ocular pathology other than cataracts. Patients with retinal or macular disease, in particular, may fail to benefit from multifocal technology, and may actually see more poorly than with a standard implant.

    Additionally, the implantation of a monofocal IOL is standard practice in cataract surgery and will be paid for by insurance along with the procedure. Implantation of a multifocal IOL is viewed by most insurance companies and Medicare as a refractive surgical option, and is not fully covered, resulting in an additional charge to the patient. Financing is available through the CareCredit program.

    Only an ophthalmologist can determine whether you are a candidate for a multifocal IOL after performing a thorough eye examination. Contact us today to schedule your consultation.

    As a service to our patients, we are pleased to offer the CareCredit card, the nation’s leading patient payment plan. With CareCredit you can finance 100% of your procedure and there are no upfront costs, no annual fees, and no pre-payment penalties. So, you can begin your refractive or elective procedure today and conveniently pay with low, monthly payments.

    CareCredit offers several payment plans so you can find one that work’s best for you. With the popular No Interest Payment Plans* there are no interest charges if you pay your balance in full within the specified time period. Monthly payments can be as low as 3% of your balance. For procedure fees from $1,000 to over $25,000 CareCredit offers 24, 36, 48, and 60 month plan options with low monthly payments available.

    CareCredit can be used by the whole family for ongoing treatment without having to reapply. And by using CareCredit for your vision care, you can save your other credit cards for household or unplanned expenses. It only takes a few minutes to apply for CareCredit and you may receive an online decision in seconds! Apply Now or see our staff for more details.