Cataracts are the most common cause of vision loss in people over 40 and the principal cause of blindness worldwide. There are more cases of cataracts than of glaucoma, macular degeneration, and diabetic retinopathy combined. In the U.S. alone, 30 million people over the age of 40 will have cataracts by the year 2020.
At Wilkinson Eye Center, we have extensive experience with the microsurgery used to remove the cataract-clouded natural lens and replace it with an artificial lens, called an intraocular lens (IOL). There are many different IOLs to choose from. They all work well to restore your vision. Some IOLs are designed to help you be more spectacle independent. These are called premium lenses. Premium lenses cost more than standard lenses covered by most insurance plans. Ultimately the choice of a stand lens versus a premium lens is up to you. We will help you understand your choices.
What is a cataract?
The lens in your eye is a transparent film that focuses images seen by the eye on the light-sensitive retina at the back of the eye. As we age, proteins build up in the lens, making the lens cloudy and impairing your vision.
Cataracts develop very slowly, and the patient usually doesn’t know his or her vision is becoming cloudier. But at some point, it will become obvious that the vision has become impaired, particularly at night. Cataracts can develop in one or both eyes, but they don’t usually progress at the same rate. The only way to treat a cataract is to remove the now-permanently cloudy lens and replace it with an IOL. It’s estimated that in the U.S. by the time a person turns 80 they have a 50 percent chance of either needing or already having undergone cataract surgery.
Intraocular Lens Options
At Wilkinson Eye Center, we offer three options for your intraocular replacement lenses. Each has different characteristics in the range of vision improvement they provide, not only returning crystal clear vision to the patient, but also addressing issues such as astigmatism and presbyopia. Here are the premium replacement lenses we offer.
Our most advanced lenses, Crystalens treats both cataracts and presbyopia (the stiffening of the eye’s natural lenses as we age that lessens the ability to focus on objects up close) at the same time. In the past, IOL options were monofocal, meaning they were only able to provide excellent vision at one point of focus, usually distance vision. Crystalens uses your eye muscles to flex the replacement lens, allowing it to focus on all distances, as your natural eye lens did. This allows you to see things at distance (watching TV, looking at distant vistas, driving), intermediate range (the kitchen counter, your car’s dashboard, faces in conversation), and near (reading, working on the computer, tallying your golf scorecard). This is a revolution of sorts in IOL technology and vastly decreases the need for glasses in most daily activities. For prolonged reading or very fine print, you may still need over-the-counter reading glasses.
Unlike some multifocal lens implants, Crystalens is designed with a smooth center, so the lens is able to deliver 100 percent of the light to the retina, even at night. This eliminates the halo effect that can come with other multifocal lenses when used for night driving.
Toric lens implants are specially designed to replace your clouded cataract lens and to also correct for astigmatism. When you have astigmatism, your cornea has an oval shape rather than the preferred round shape. This makes it more difficult to focus at certain distances. In the past, astigmatism has limited the degree of improvement that could be gained with IOLs, because they didn’t deal with astigmatism. Glasses were still required to correct the deficiency. Toric lenses correct the astigmatism.
Once you’ve opted for toric lenses, you’ll also need to choose your vision ranges from one of the following options:
- Both lenses are set for distance vision
- Both lenses are set for up close vision
- Monovision: One eye is set for distance, and the other is set for mid-range or near vision
Your toric lenses will deliver sharp vision, but you may still need glasses for certain activities such as reading.
Monofocal or Standard Lenses
Standard intraocular lenses deliver one point of focus: close, mid-range, or distance. You can choose the distance you will see clearly and use glasses for other distances.
Or, you can opt for monovision, where the lens in your dominant eye is set for distance vision and your non-dominant eye is set for mid-range or near vision. It may seem that this arrangement would make the person disoriented, but the brain adapts remarkably, giving the patient a fuller range of vision with less dependence on glasses.
The team at Wilkinson Eye Center will help you with the decision on the type of IOL you desire. Note that, while insurance and Medicare cover cataract surgery and IOL replacement, sometimes premium lens choices such as Crystalens require additional out-of-pocket contribution from the patient.
The Multifocal lens is designed to reduce your dependence on eyeglasses. The multifocal lens is a specially engineered optic which provides both a distance focus, and a near focus at all times. When doing a task your brain will learn to automatically select the correct focus. For example, you will need to figure out at what distance to hold a piece of reading material. Many patients report over time it improves.