What is a cataract?

The natural lens inside the eye becomes cloudy which is a normal aging process. This causes blurry vision and glare. Cataract surgery involves removing the cloudy lens and replacing it with a new intra ocular lens (IOL) which has a prescription in it. At the cataract evaluation, it will be determined if you have a visually significant cataract and if you decide to have cataract surgery, you will be measured for the appropriate power of the IOL at a separate preoperative visit.

NOTE: if you have had LASIK or PRK in the past, please try to obtain your laser records if possible. This will help with determining the correct power of your eye which can affect the prescription of the IOL that is placed in your eye. Although these records are very helpful, if obtaining them is not possible, we will still be able to move forward with surgery.

What are my Intra ocular Lens (IOL) options?

You will have to make some decisions yourself about which IOL is best for you. Your surgeon will help guide you. Part of the decision is where you want your focal point to be. You will also need to decide whether you mind wearing glasses after surgery or not. Some IOLs that make you more independent from glasses are considered elective. Insurances don’t pay for these elective upgrades and this will be an out of pocket expense to you. Not everyone is a candidate for every IOL.

The options for focal points are:

1. A) Distance: driving, TV, most sports (far away)
2. B) Intermediate: computer, dashboard, reading music (arms length away)
3. C) Near: reading a book, sewing, needle work (close to face)

There are 3 general categories of IOLs for you to consider:

1. Standard/Basic IOLs

– NO EXTRA COST

• This is paid for by your insurance, no extra cost to you. You will still have your normal copays and deductibles but this IOL does not cost anything extra. Standard IOLs are mono-focal so you will only get one focal point with this IOL when you don’t have glasses on. You will have to choose a focal point of distance vision or intermediate vision or near vision. These IOLs do not fix astigmatism. Typically, patients who choose this IOL still need driving, computer, and/or reading glasses to obtain their best vision.

2. Astigmatism correcting IOLs

– Extra out of pocket cost for this category of lenses.

• These are known as Toric IOLs. These IOLs are designed to eliminate or reduce your astigmatism. Astigmatism comes from the shape of your cornea and astigmatism makes things blurry. Astigmatism can be corrected with glasses or contact lenses or you can choose a Toric IOL. We measure astigmatism at the cataract evaluation and at the preop visit. Toric IOLs are mono-focal so you will only get one focal point with this IOL when you don’t have glasses on. You will have to choose a focal point of distance vision or intermediate vision or near vision. The benefit of the Toric IOL is that your astigmatism has been eliminated or reduced and your chosen focal point should be in good focus without glasses. You will still need glasses for the other focal points. This is an excellent option for people with astigmatism.

3. Premium IOLs

– Extra out of pocket cost for this category of lenses. If there is a significant residual refractive error after Premium IOL, we offer a free Lasik/PRK enhancement.

Multifocal IOLs (MFIOLs)

• These IOLs are designed to give you good distance, good intermediate, and good near vision at the same time. MFIOLs can fix astigmatism, too. The benefit of MFIOLs is that they should give you a full range of vision without glasses. These IOLs are not perfect. With MFIOLs, one can expect to see some night time rings and halos around lights. People that are perfectionists might find these night time symptoms more bothersome than people that are more easy going. Sometimes people with MFIOLs still need low powered reading glasses for fine print and reading in dark conditions. An example of a very commonly used MFIOL in the US is the PanOptix IOL.

Extended Depth of Focus IOLs (EDOF)

• These are designed to give you good distance and good intermediate vision without glasses. EDOF IOLs can fix astigmatism, too. You will most likely still need reading glasses. The benefit of EDOF IOLs is that they should give you more range of vision than a standard mono-focal lOL without glasses. EDOF IOLs have less night time issues than MFIOLs. An example of a very commonly used EDOF IOL in the US is the Vivity IOL.

Accommodating IOLs

• These IOLs are designed to give you good distance and good intermediate vision without glasses. Accommodating IOLs can fix astigmatism, too. You will most likely still need reading glasses. Accommodating IOLs are designed to utilize the eye muscles to move in the eye to give you more than one focal point. In some eyes, the muscles are atrophied and this IOL doesn’t move in the eye. Because of this reason, these IOLs are not as commonly used as the MFIOLs or EDOF IOLs. The benefit of accommodating IOLs is that they should give you more range of vision than a standard mono-focal IOL without glasses and there should be less night time glare and halos as compared to MFIOLs and EDOF IOLs. An example of an accommodating IOL in the US is the Crystalens.