During cataract surgery, your surgeon removes your eyes’ clouded lenses and replaces them with new, clear, artificial lenses. Your eyes’ new intraocular lenses (IOLs) are a lifelong investment, so it’s important to choose lenses that will optimize your visual experience. Your choice of replacement lenses will have a significant impact on how you will see in a variety of conditions, including:
- Near, intermediate, and distance
- Daytime and night-time
- In different lighting conditions
Unfortunately, there is no right or wrong decision regarding which lens is best. Many factors play into choosing the best lens for you, including:
- Your overall eye health
- Your budget
- Your lifestyle and activities
- Your visual priorities
At Horizon Eye Care, we’re big believers of keeping things simple and providing information in a manner that’s accessible to you. That’s why we’ve broken down lens choices in a way that’s easy-to-understand so that you can feel empowered to make an informed decision regarding which lens is right for your eyes and your life. We’ll review your priorities during your cataract exam so we can discuss which options will be the best for you.
Why Does the Lens Choice Matter?
Cataract surgery removes the clouded natural lens and replaces it with a clear artificial one. In the past, all replacement lenses corrected for one focal distance, typically distance, meaning patients still needed glasses for reading and often for intermediate tasks too. Advances in lens technology have expanded the options considerably.
Your choice of IOL affects how clearly you see at different distances, whether you will need glasses after surgery, and how your vision performs in various lighting conditions.
Standard Lenses (Monofocal IOLs)
Originally, all replacement lenses focused light at one focal point. These lenses are referred to as monofocal lenses. Most patients who had cataract surgery with monofocal IOLs still had to wear corrective lenses, such as bifocal glasses, to enhance their near-vision after cataract surgery. Today, monofocal lenses are considered the standard lenses that are covered by Medicare and most insurance.
With monofocal lenses, most patients wear reading glasses to optimize their near-vision after cataract surgery. Your surgeon may be able to implant monofocal lenses in a pattern referred to as monovision. With monovision, one eye would be corrected for distance-vision and the other eye corrected for near-vision. Monovision can be helpful for some patients, however, the brain needs time to adjust to monovision and it’s not successful for all patients.
Who are good candidates for monofocal IOLs?
- Those who don’t mind wearing reading glasses after cataract surgery
- Those whose top priority is good distance vision
- Those who want the most insurance-covered lens option
- Those with certain corneal conditions that would prevent them from receiving premium lenses
Premium Lenses
Many patients choose premium lenses as a worthwhile investment to reduce or eliminate their dependency on corrective lenses after cataract surgery. Premium lenses include multifocal and Extended Depth of Focus (EDOF) lenses, which are not covered by insurance. Multifocal lenses focus light at different distances including near, intermediate, and distance vision, helping you see well at all focal lengths. EDOF lenses create an elongated depth of focus to give you a wider range of clear-vision. Multifocal lenses can sometimes cause more glare and halos at night; however, “most” symptoms subside as the brain adjusts to the new lenses.
Who are good candidates for premium lenses?
- Active individuals who don’t like wearing glasses
- Those who are looking to be independent from corrective lenses
- Those without certain eye conditions that may impact their success, such as macular degeneration or advanced corneal disease
Toric Lenses
If your cornea is shaped like a basketball instead of a soccer ball, you likely have a condition called astigmatism that impacts how clearly you see. Toric intraocular lenses are available to correct for the irregularly shaped cornea associated with astigmatism. These lenses are available in monofocal and multifocal versions. Individuals who want to reduce their dependency on bifocal lenses are typically the best candidates for toric IOL’s
Who benefits most from premium lenses?
- Active patients who want to minimize glasses dependence
- Those with astigmatism who want the most complete correction possible
- Patients with realistic expectations about the adaptation period for multifocal optics
- Those who do not have conditions like macular degeneration or significant corneal disease that can affect premium lens outcomes
Light Adjustable Lenses (LAL)
New and still being perfected, Light Adjustable Lenses allow patients to fine-tune their vision after cataract surgery. After receiving LALs and recovering from surgery, patients return to the office where they receive a UV-light treatment. After their first “test drive,” patients return to receive more UV-light treatments if necessary to achieve optimal vision. After achieving ideal results, patients receive a final treatment that locks the lens into place. Patients wear UV-protection after each visit until the lens is finalized.
Who are good candidates for LALs?
- Active individuals who don’t like wearing glasses
- Those who are looking to be independent from corrective lenses
- Those without certain eye conditions that may impact their success, such as macular degeneration or advanced corneal disease
- Those who have previously undergone procedures such as LASIK that can make it difficult to calculate the right IOL power
LALs take special consideration because patients need to commit to returning for additional UV-light treatments for optimal results. Patients may require two to four additional visits to achieve ideal results. These follow-up visits can take place over a period of several weeks.
We hope this breakdown of IOLs helps you feel more prepared for your cataract surgery conversation. At Horizon Eye Care, we’re committed to ensuring that you feel empowered to make the best decision regarding which lens will be the best for you. We’d be happy to answer any of your cataract or lens-related questions. Give us a call at 704-365-0555 or schedule an appointment online. We’re looking forward to speaking with you soon.
