STANDARD VERSUS PREMIUM INTRAOCULAR LENS IMPLANT OPTIONS

Patients now have options for cataract surgery

If you are diagnosed with cataract formation, Moretsky Cassidy Vision Correction wants you to be aware that there are different treatment options available for you.  Cataracts develop when the natural lens of your eyes become cloudy, affecting your sight.  Visually significant cataracts can be removed and replaced with an intraocular lens implant on an outpatient basis.  Cataract surgery is indicated when the quality of your vision interferes with your daily activities, be it driving, reading, or just unusual glare or halos associated with lights.  Years ago, patients were advised to defer cataract surgery until the cataracts became "ripe."  Cataracts are different than tomatoes, they do not need to get ripe before they are treated.  After the cataract is removed, it is replaced with an intraocular lens implant that is similar to a small soft contact lens which contains an optical prescription that is matched for you, much like your glasses.  However, we now have different treatment options available to address this prescription, the standard or premium implants. 

Standard implant options

Traditionally, the standard intraocular lens was designed to improve vision to a level the eyes saw before cataract formation occurred, with the additional aid of glasses.  Ophthalmologists today can insert a standard implant which can provide single distance vision only.  Reading glasses or bifocals are then used for fine tuning and reading small print.  Most patients accept this, as they are accustomed to bifocals, progressive lenses, or reading glasses.

Presbyopia

Presbyopia is a condition that requires the aid of reading glasses or bifocals.  This begins occurring around age 45 and continues to progress.   Modern technology intraocular lens implants (presbyopia correcting) are now available to permit patients to be less dependent on bifocals or reading glasses, both for distance and near. 

Premium implant options –  Presbyopia correcting implants

When deciding on cataract surgery options, you can now choose a premium technology implant that can enhance your vision, allowing you to see near, far, and in between without glasses or contacts.  With Presbyopia Correcting Implants, you can expect a full range of vision, "glasses free," typically 95 to 100% of the time.  Using modern technology intraocular lenses and advanced surgical technique, you may, once again, eliminate your dependence on bifocals and reading glasses, yet still enjoy clear far away vision. 

Not all cataract patients are candidates for this premium presbyopia correcting technology, so our doctors will need to evaluate your eyes before you will know if this is right for you.  Also, not all ophthalmologists perform presbyopia correction implants with cataract surgery.  Dr. Moretsky and Dr. Cassidy have over 25 years of refractive surgery experience and perform a variety of different refractive surgery procedures, including LASIK.  They have a unique skill set and vast experience with all types of refractive surgery and intraocular lense implants.

We are pleased to offer the following premium presbyopia correcting implant options, ReStor®, ReZoom™, and Crystalens®. 

Other premium intraocular lens options include the Toric intraocular lens which corrects for astigmatism.  This improves the quality of vision for distance in patients with excess astigmatism.  With Toric lenses, patients will still require reading glasses but will enjoy a new level of distance vision that would previously require contact lenses or glasses. 

Medicare and commercial insurance companies cover the fee for standard intraocular lens implants.  However, you are responsible for the additional cost of upgrading to a premium intraocular lens technology.  Financing is available for patients who are interested in taking advantage of interest free terms, as well as monthly installments.  To sign up for financing, click on the Care Credit logo. 

According to Food and Drug Administration (FDA) studies, the ReStor® lens provides the highest percentage of spectacle independence in patients for distance and near when implanted in both eyes during cataract surgery.  A good ReStor® candidate would typically include a patient who is an avid reader (books, magazines, crossword puzzles), and someone who enjoys crafts, such as sewing.  These patients also enjoy traveling and sightseeing.  Good lighting is helpful for near vision.  Patients that might benefit more from a different type of presbyopia correcting implant would be a patient who spends more time on a desktop computer, versus a laptop computer, or who needs to see better at intermediate ranges, such as cooking and working at arm's length.  With the ReStor® lens, your near vision may be closer than you remember it before surgery.  Expect to bring things closer to read more comfortably.  You may also need to move your desktop computer closer and make minor life-style adjustments, as your eyes adjust to your new vision.  However, the ReStor® lens will provide the best close vision of all the presbyopia correcting lenses available. 

ReZoom™

The ReZoom™ lens is reported to give better distance vision, because the center portion of the lens is distance dominant, only.  The ReZoom™ lens tends to be a better option for those who require better intermediate vision range.  A patient that may benefit more from a ReZoom™ presbyopia correcting implant, maintains an active lifestyle, and enjoys golf, tennis, and other physical activities and frequently uses a desktop computer.  The ReZoom™ presbyopia implant may have a higher incidence of halos around bright lights at night than the ReStor® lens, although some patients may observe these symptoms with either of these lenses. 

Crystalens®

Crystalens® is a monofocal lens that flexes.  This is unlike the ReStor® or ReZoom™ lens which rely on sharing light between distance and near.  Since there are no multiple focus principles involved with this lens, it is reported that patients enjoy better distance vision, especially while driving at night.  Crystalens® has been reported to be more successful with patients who have had previous refractive surgery, especially radial keratotomy.  Crystalens® does not provide as good close up vision, and it is necessary to employ some postoperative blended or monovision correction for best close vision outcomes.  Blended or monovision relies on a slight increased near vision in one of the two eyes, usually the nondominant to provide a better depth of focus for close vision.  Crystalens® patients tend to be more dependent on reading glasses for real fine print, but may have better quality vision for intermediate and distance than the ReStor® or ReZoom™ lens.  Patients that may benefit more from Crystalens® are typically more easygoing and have active lifestyles enjoying tennis, golf, and other sporting or recreational activities, would not mind rarely wearing reading glasses for smaller print and spend a lot of time on a desktop computer.  Patients that drive a lot at night or pilots may also be better candidates for the Crystalens® presbyopia correcting implant.

Conclusion

These implants are wonderful alternatives to routine use of reading glasses or bifocals.  However, under rare circumstances, patients may still rarely require the need for glasses.  Presbyopia correcting intraocular lenses are by far a modern technologic advancement, and some patients describe as a near modern miracle of medical science.  Having realistic expectations and understanding the benefits and compromises involved in presbyopia correcting intraocular lens technology is important before deciding if one of these lenses would be right for you. 

Dr. Moretsky and Dr. Cassidy will examine your eyes and interview you to help decide which lens is best for you.