Cataract surgery was revolutionized almost forty years ago when the first intraocular lens (IOL) was implanted into the eye. Placing this artificial implant into the eye allowed patients to avoid using hard contact lenses and thick “coke bottle” glasses after surgery. These implants are selected based upon the measurements of each individual eye and allow patients to have good distance vision. These implants are called monofocal impants as they focus light just at one distance. Patients therefore still need to use reading glasses after surgery.
The next revolution in impant technology has just begun. After much research, a new generation of implants have been developed to give additional benefit beyond what the monofocal lenses could provide. These premium IOLs include multifocal, accomadative, toric, and aspheric lenses. This first generation of multifocal and accomodative implants will for the first time allow patients to have both distance and near vision with less dependency upon glasses. Toric IOLs help to correct for astigmatism improving vision at all distances. Aspheric IOLs can help to decrease higher order aberrations for patients who have had laser vision correction or those bothered more by glare.
Not all patients will be candidates for these new premium IOLs because of visual demands and intrinsic differences in every individual eye. Special care and attention must be given in choosing which patients will benefit from these premium lenes. Considerations include occupation, hobbies, pre-existing eye diseases, pupil size, astigmatism, and tolerance for variabilities in vision.
Best vision is achieved only after both eyes are corrected. Because only one eye is operated upon at one time, there will be a few weeks between surgeries before optimal vision is achieved. Glares and haloes, especially at night, are common for many weeks after surgery although most patients adapt over time. If the vision is still not optimal, then touch up or enhancement procedures are possible.
These new technology implants require complex decisions, skills, and understanding to achieve satisfactory vision for patients. These premium IOLs are not covered by insurance and will require additional payment. For the right patient, these lenses can provide better vision than we have ever attained before.
Acrysof Toric IOL