Intraocular Lens Options

Cataract surgery involves removing a clouded lens and replacing it with an artificial intraocular lens to improve your vision. It is important to understand that not all IOLs are the same. Some can help you see near or far even better. Choosing the right lens for you can be confusing. Understanding the various lens options is essential before making your lens choice. Your eye health, prescription, and the amount of corneal astigmatism plays a big part in determining which lenses will give you the best results.

How to Choose The Best Lens

The primary decision is the type of vision you want to have after surgery:

  • Good Distance Vision – but wear reading glasses

  • Good Reading Vision – but wear distance glasses

  • Good Distance Vision plus Computer Vision

  • Good Distance, Computer, and Reading Vision

  • Monovision – distance vision in one eye and reading vision in the other eye. Many patients cannot tolerate monovision since it limits depth perception resulting in an increase in the risk of falling.

Lens Options for Cataract Surgery

Types of IOL Lenses

The main types of intraocular lenses are:

  • Monofocal lenses- designed to provide the best possible vision at one distance. Most people who choose monofocals have their IOLs set for distance vision and use reading glasses for near-vision tasks.

  • Multifocal IOLs have many corrective zones built into the lens (much like bifocal or trifocal eyeglasses). This allows you to see both near and far objects. Also, some multifocals may correct intermediate vision.

  • Extended depth-of-focus (EDOF) IOLs have an extended corrective zone. This zone is stretched to allow distance and intermediate vision.

  • Accommodative lenses can also correct vision at all distances. The lens uses the natural movements of your eye’s muscles to change focus.

  • Toric lenses have extra built-in correction for astigmatism.

You have a one-time opportunity to select the lens that's going to give you the best possible vision and improve your quality of life. It’s important for your doctor to explain all the options so the best choice can be made.

Which Artificial Lens Can You Afford?

Insurance does not cover all IOL types. Medicare and most insurance companies do cover the cost of the monofocal lens. These lenses have been in use for decades and are the most popular type.

Other options such as multifocal, EDOF and accommodative IOLs can also reduce the need for glasses or contact lenses. The ability to read and perform other tasks without glasses varies from person to person. These IOLs are often called “premium” lenses because they provide more extended vision than monofocals. They are also often not covered by insurance.

Which Lens is Right For Me?

Cataract surgery involves removing a clouded lens and replacing it with an artificial intraocular lens to improve your vision. However, not all IOLs are the same. Choosing the right IOL can be difficult. Our doctors will help guide you to an informed decision that best fits your budget and your lifestyle.

Does your lifestyle rely on near vision?

One option is to set the monofocal IOL for near vision and use glasses for distance vision tasks, like watching TV and driving. If you spend a lot of time looking at digital devices or you're nearsighted and love to read without glasses this may be the best option for you.

Alternatively, you may find eyeglasses inconvenient and want to avoid them altogether. If so, you could opt for monofocal lenses but set one lens for distance vision and the other lens for near vision. This choice is not for everyone. For many people, the brain adapts and can synthesize the information from both eyes to provide adequate vision at all distances. Before cataract surgery you can try this option out by wearing monovision contact lenses for a period of time. This will help you figure out if monovision works for you.

Do you frequently drive at night?

If night driving is important, you might want to steer clear of multifocal or EDOF lenses. Side effects such as glare, halos around lights or loss of contrast (resulting in dull vision) may occur with these lenses, most commoningly at night or in dimly lit places. Most people adapt to these effects, but those who drive at night a lot may be happier with monofocal IOLs.

Do you have moderate to high astigmatism?

With astigmatism, the cornea is not curved like a basketball but shaped more like a football. One curve is longer than the other. This distorts both near and distant objects. People with moderate to high astigmatism are usually happier with toric IOLs.

Another procedure that your doctor might recommend is called limbal relaxing incisions (LRIs). This procedure is common to help reduce astigmatism. They perform this at the time of cataract surgery or separately. Insurance may not fully cover toric lenses or LRIs.

Do you have other eye conditions?

Multifocal and EDOF lenses are generally not recommended for people with vision loss from glaucoma, macular degeneration or other eye diseases. These IOLs allow less light into the eye so they can make things worse for people with vision loss. If avoiding glasses is important and you have eye damage, monovision may be a better option.

During your initial consultation with the doctors at SightMD, they will go through the options you have regarding intraocular lenses. If you have cataracts and are considering getting surgery, contact our office today to set up your consultation!

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