Advances in Intraocular Lens Options
Types of Intraocular Lenses (IOLs)
Multifocal Lenses
State-of-the-art multifocal intraocular lenses reduce the need for reading glasses after cataract or lens replacement surgery. These lenses are designed to address the problem of presbyopia, in which people over the age of 40 begin to lose their ability to read or see up close. In the past, when an artificial lens, called an intraocular lens implant or IOL, was placed inside the eye during cataract or lens replacement surgery, it could only focus at a single distance. These IOLs are called single-focus IOLs and allow an eye to see either far away or close-up, but not both.
Advanced intraocular lenses, called multifocal IOLs, provide correction for both near and distance vision. And both near and far objects can be in focus at the same time. Many people get used to multifocal IOLs right away. Others feel a little imbalanced at first but get used to it within a matter of days or weeks.
Patients with certain eye conditions, including glaucoma, diabetic retinopathy, retinal scar tissue, corneal scars, or who previously underwent radial keratotomy, are ineligible for this type of lens. Your doctor will review your examination findings to determine if you are a good candidate.
Light Adjustable Lenses
Light adjustable lenses allow your physician to make precise adjustments to the lens after surgery until you reach the clearest possible eyesight. The lens material can be molded and shaped by shining a high-tech UV light at precise areas of the lens to customize your results. The UV treatment can be performed up to three times per eye, allowing fine-tuning of your vision. Your treatment will conclude with two additional light treatments that “lock in” your custom prescription.
Throughout treatment, you’ll need to wear special UV protection glasses while outdoors or when in direct sunlight indoors to ensure that your lens doesn’t accidentally change in response to UV light in your environment. Some patients with medical or eye conditions may not be suitable for this technology.
The Symfony Lense Offers Extended Depth of Field
The Tecnis Symfony® lens, approved by the FDA in July, 2016, is an exciting advance in presbyopia lens technology. It provides excellent vision without glasses for distance (driving, watching TV) and intermediate visual tasks (computer work), and good vision quality at near distance (reading labels, cell phone) for most patients. The design of this new lens is also a leap forward in minimizing concerns about glare and halo that some patients experience after cataract surgery.
In addition, the FDA approval includes a version of the lens for people with astigmatism—the Tecnis Symfony Toric IOL. This means that patients with greater levels of astigmatism can now potentially choose to have a presbyopia-correcting lens without having to undergo other surgical procedures to correct the astigmatism. Visual results without glasses and patient satisfaction have been very high with this lens in reported clinical trials.
Astigmatism Correction with Toric Lenses
The cornea (front window) of the eye can sometimes be more cone-shaped than spherical, which is called astigmatism. If you have astigmatism, leaving it untreated would mean you would need glasses for both distance and near vision after cataract removal. Your doctor can use laser reshaping of the cornea or an astigmatism-correcting lens implant to treat your astigmatism at the time of cataract removal.
Accommodating Lens Implants
These implants change position within your eye based on your eye muscle effort. Accommodating lenses can treat astigmatism, but give slightly less near power than multifocal lenses. They are typically used in patients who aren't eligible for multifocals because of mild or moderate glaucoma, diabetic retinopathy, retinal scar tissue, corneal scars, or prior radial keratotomy. Medicare provides partial coverage for these lenses.
