During cataract surgery, the eye’s natural lens, which has become cloudy from the cataract, is carefully removed. Because this lens is responsible for focusing light, it must be replaced to restore clear vision. A new, clear artificial lens, called an intraocular lens (IOL), is placed in the same position within the eye. This replacement lens is permanent and designed to help refocus light properly onto the retina, allowing you to see clearly again.
The choice of intraocular lens is highly individualized and depends on your visual goals after surgery. Some patients prioritize the sharpest possible distance vision and are comfortable wearing reading glasses, while others prefer greater independence from glasses for activities like reading, computer use, or driving. Factors such as your daily routine, tolerance for visual side effects (such as glare or halos), and the presence of astigmatism all play an important role in selecting the most appropriate lens. During your consultation, we will review these considerations in detail to help tailor a lens choice that best aligns with your expectations and lifestyle.
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Intraocular Lenses
Depending on the type and power of Premium IOLs (premium intraocular lenses) that are implanted into the eyes during cataract surgery, one’s dependence on glasses can be greatly reduced and sometimes eliminated. Dr. Lally will discuss the lens options best suited for you based on your individual needs and overall health of the eye.
There are three major groups of intraocular lenses that can be implanted into the eye during cataract surgery:
- Monofocal lenses
- Toric lenses
- Multifocal lenses
Monofocal Lenses
The Monofocal lens is the traditional, single-focus lens that enables the patient to focus clearly on a single distance, either distance vision or near vision. The patient will need a pair of glasses to see clearly at near (if uncorrected distance vision is the desired post-surgical result) or at distance (if uncorrected near distance vision is desired post-surgical result). The monofocal lens does not correct for underlying corneal astigmatism which may necessitate astigmatic spectacle correction (glasses or contacts) after surgery.
Toric Lenses
The Toric lens is a type of intraocular lens that corrects for corneal astigmatism from within the eye. A corneal astigmatism is a condition in which the cornea is not perfectly spherical (like a basketball) but rather is steeper on one side than the other (like a football). The toric intraocular lens corrects for the irregularly shaped corneal from inside to the eye to let the patients see clearly post-operative without glasses. Toric intraocular lenses are available in both monofocal and multifocal variants.
Multifocal Lenses
The Multifocal intraocular lens (available in both bifocal or trifocal) is a lens that can significantly lessen a patient’s dependence on glasses for both distance and near vision. This lens uses the principles of diffraction and refraction to focus light though different sections of the lens based of the visual demand. It is usually recommended that this type of lens in placed in both eyes for best binocular vision and for the brain to adapt to the vision. When using this lens, Dr. Lally recommends that the Femtosecond laser is used to assist in creating a “perfect” opening in the top of the cataract’s lens bag so that the multifocal lens centers beautifully within the eye. The Multifocal lens comes in both a toric and non-toric variety.
This lens is not recommended for patients who have any disease process in the macula (the center part of the retina). Dr. Lally will determine this and discuss with you after appropriate testing and examination. The most common complaint from some patients using this lens is seeing starbursts and halos around bright lights, especially at night. These symptoms are generally mild, and the brain tends to adapt to the phenomenon. While great distance, intermediate and near vision can be attained using this lens, a pair of reading glasses may still be needed for reading very fine print, especially in poorly lit conditions.
While all cataract surgery is billed through insurance, only the standard, monofocal intraocular lens is covered by insurance. Your surgeon can discuss with you the cost and payment plans associated with the toric and multifocal lenses and the Femtosecond laser.
Choosing the most appropriate intraocular lens can be difficult and confusing. At Summit Eye Surgeons, Dr. Lally and her staff will guide you to an informed decision that best fits your needs, lifestyle and budget. Dr. Lally will discuss with you in much greater detail which lens option is best suited for you.
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