During cataract surgery, a cataract surgeon removes the cataract, which is the eye’s natural lens that has become cloudy and yellow. The capsule that was holding the cataract is left in place inside the eye. In order to replace the optical focusing power of the lens (cataract), the cataract surgeon places an artificial acrylic intraocular lens (IOL) implant within the capsule so that the eye can see again. Your cataract surgeon can choose a lens to target a certain refraction (glasses prescription) after surgery, and in some cases you may not need glasses at all.
Lens Options
When discussing cataract surgery in Traverse City, MI with a patient, I use a variety of information to help the patient decide which lens is best for them. The first piece of information is the patient’s current glasses prescription (refraction), near-sighted and far-sighted people have had quite different visual experiences their entire lives, so this starting point can drive a lot of the decision-making. For instance, many near-sighted patients have always read without their glasses; it is important to understand if they want to continue to be able to do this following cataract surgery.
Will I Need Glasses After Cataract Surgery?
The next question I ask is how a patient feels about wearing glasses, either all the time, just for reading, or both. Depending on this answer, I begin discussing the various IOL options available to the patient that can help them achieve their visual goals. At the same time I mention the financial aspect of the decision; medical insurance covers cataract surgery with a standard acrylic IOL (subject to deductible, co-insurance, and/or copays), but insurance companies do not cover advanced technology IOLs (toric, multifocal, and light-adjustable IOLs). They view these premium IOLs as something “cosmetic”, akin to LASIK or a face lift. As such, the patient must pay out of pocket for these upgrades. The cost of various IOLs varies considerably, but a ballpark figure is that they can cost between $1,000 and $4,000 per eye.
I think it is important to mention the financial aspect of things relatively early in the discussion because it is often at this point that a patient will say “oh wow, that is a lot of money and I can’t afford that”. At that point I let the patient know that it is perfectly OK to go with the standard implant covered by insurance, and that it is still a high-quality lens and I expect their vision to be great after surgery, they just may need glasses to see their best at all distances. If someone is interested in learning more about their premium lens options then the discussion moves forward.
At this point the next piece of information I obtain is whether the patient is interested only in seeing well in the distance without glasses, or if they are interested in reducing their need to wear glasses both for distance and closer up (computer and reading). If they are interested in just distance vision without glasses, then it is a matter of evaluating their level of astigmatism. The Light-Adjustable Lens (LAL) is great at correcting mild to moderate levels of astigmatism. Above a certain threshold of astigmatism I will recommend a toric (astigmatism-correcting) IOL for good distance vision without glasses; if the patient is fortunate enough to have minimal corneal astigmatism, then we may be able to achieve their visual goals with the standard monofocal lens.
For patients interested in decreasing their dependency on glasses at all distances, I start discussing the Light-Adjustable Lens and the PanOptix trifocal lens. These lenses are made to create an elongated focal point, resulting in a patient being able to see well in the distance and more up close without needing reading glasses. Being able to vastly reduce the need for glasses has long been a goal of the companies that make IOLs, and the Light-Adjustable Lens and PanOptix are a big step forward in this regard. In my opinion (and those of many of the most respected cataract surgeons in the world), the Light-Adjustable Lens and PanOptix are the best lenses available when it comes to reducing a patient’s need for glasses at most distances. With that said, they are not perfect; some patients may still require low power reading glasses to read small font for extended periods of time or with low light.
You must be logged in to post a comment.