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For those with cataracts, the traditional treatment replaces the eye’s natural lens with a mono-focal or single vision, intraocular lens (IOL). Although this allows patients to see at a distance, they will still need bi-focals for near vision activities, like reading, or intermediate vision activities, like working at the computer. The need for extra glasses is lessened or eliminated with Lifestyle Lenses.
Lifestyle Intraocular Lens Options
Unlike traditional mono-focal lens, lifestyle intraocular lens options allow patients to see more clearly at various distances or correct astigmatism while reducing dependence on contact lenses or glasses. Lifestyle Lenses are a great option for those with aging eyes looking to eliminate their need for reading glasses and to correct astigmatism.
Clear Lens Exchange
Some patients without a cataract may choose a Clear Lens Exchange to improve their vision. A clear lens exchange removes the clear, natural lens and replaces it with a multifocal intraocular or accommodating intraocular lens also reducing or eliminating the need for glasses. In addition, patients with lifestyle lenses have the benefit of improved vision without ever having to worry about the development of cataracts since the implantable lens replace your eyes natural lens.
This IOL type is set to provide best corrected vision at near, intermediate or far distances. Most people who choose monofocals have their IOLS set for distance vision and use reading glasses for near activities. On the other hand, a person whose IOLs were set to correct near vision would need glasses to see distant objects clearly.
Some who choose monofocals decide to have the IOL for one eye set for distance vision, and the other set for near vision, a strategy called “monovision.” The brain adapts and synthesizes the information from both eyes to provide vision at intermediate distances. Often this reduces the need for reading glasses. People who regularly use computers, PDAs or other digital devices may find this especially useful. Individuals considering monovision may have a trial with monovision contact lenses to learn how well they can adapt to monovision. Those who require crisp, detailed vision may decide monovision is not for them. People with appropriate vision prescriptions may find that monovision allows them see well at most distances with little or no need for eyeglasses.
Presbyopia is a condition that affects everyone at some point after age 40, when the eye’s lens becomes less flexible and makes near vision more difficult, especially in low light. Since presbyopia makes it difficult to see near objects clearly, even people without cataracts need reading glasses or an equivalent form of vision correction.
Monofocal
This IOL type has been used for decades
How IOLs Work
Monofocal,
Multifocal/Accommodative
or Toric?
Cataract Surgery
vs Clear Lens Exchange
A clear lens extraction with intraocular lens implant and a cataract extraction with introcular lens implant are very similar surgical procedures. Most people are familiar with cataract surgery because they have had friends or relatives who have had their cataracts removed. In fact, it is the most frequently performed surgicial procedure. But, there are some important differences between the two procedures that are necessary for you to understand so that you can make the very best possible decision.
Patients with cataracts experience increasing loss of vision due to the progressive clouding of the natural lens of the eye. When the vision decreases to the point that quality of life is affected, a cataract extraction with intraocular lens is recommended. This means that the cloudy lens in the eye will be removed and replaced witlh an artificial lens. If cataract extraction is not performed the vision will continue to worsen and eventually, the lens will become so cloudy and dense that the vision may be lost and the eye may develop other problems like glaucoma. For this reason, cataract surgery is considered medically necessary and most of the surgery is usually covered by an insurance plan.
With either type of surgery, the lens is removed from the eye and replaced with an artificial, intraocular lens. The type of lens to be implanted will be determined by you and your surgeon. See Lifestyle Intraocular Lens Options for additional information.
Clear lens extraction patients don't wait for a cataract to form. They are often uncomfortable wearing glasses and/or contact lenses, or they may have a career requiring good, uncorrected, vision. They usually are not good candidates for other types of refractive surgery so they choose to correct the refractive error by having the natural, clear lens of their eye removed and replaced with an artificial lens that will correct the refractive error.
Clear lens extraction is considered a cosmetic or elective surgery and it is usually not covered by an insurance plan.
Like your eye’s natural lens an IOL focuses light as images, received from the cornea and pupil at the front of the eye, onto the retina, the sensitive tissue at the back of the eye that relays images through the optic nerve to the brain. Most IOLs are made of a flexible, foldable material and are about one-third of the size of a dime. Like the lenses of prescription eyeglasses, your IOL will contain the appropriate prescription to give you the best vision possible.
Advantages of Multifocal and Accommodative
The ability to read and perform other tasks without glasses varies from person to person but is generally best when multifocal or accommodative IOLs are placed in both eyes.
For many people, these IOL types reduce but do not eliminate the need for glasses or contact lenses. For example, a person can read without glasses, but the words appear less clear than with glasses.
Usually six to 12 weeks are required after surgery on the second eye for the brain to adapt and for full visual improvement to be realized with either of these IOL types.
Toric
This is a monofocal IOL with astigmatism correction build into the lens.
This eye condition distorts or blurs the ability to see both near and distant objects. With astigmatism the cornea (the clear front window of the eye) is not round and smooth (like a basketball), but instead is curved like a football. People with significant degrees of astigmatism are usually most satisfied with toric IOLs.
People who want to reduce (or possibly eliminate) of the need for eyeglasses may opt for an additional treatment called limbal relaxing incisions, which may be done at the same time as cataract surgery or separately. These small incisions allow the cornea’s shape to be rounder or more symmetrical.
Multifocal vs Accommodative
These newer IOL types reduce or eliminate the need for glasses or contact lenses.
In the multifocal type, a series of focal zones or rings is designed into the IOL. Depending on where incoming light focuses through the zones, the person may be able to see both near and distant objects clearly.
The effectiveness in a specific person may depend on the size of his/her pupils and other eye health factors. People with astigmatism can ask their physician about toric IOLs and related treatments.
Side effects such as glare or haloes around lights, or decreased sharpness of vision (contrast sensitivity) may occur, especially at night or in dim light. Most people adapt and not bothered by these effects, but those who frequently drive at night or need to focus on close-up work may be more satisfied with monofocal IOLs.
The design of the accommodative lens allows the eye’s ciliary muscles to move the IOL forward and backward, thus allowing the focus to change much as it would with a natural lens and enabling near and distance vision. In some patients the ability of this IOL to move is lost. In effect the IOL is converted to a monofocal.
PanOptix
Trifocal IOL: distance, intermediate and near vision
This IOL maybe the best of all worlds. It is a multifocal lens with excellent distance and near vision. Alcon designed it to provide intermediate vision as well. Also, astigmatism correction is available with this lens. It has been used in Europe for five years and was introduced into the US market in the summer of 2019