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Cataract Lens Implants
Posted by: DeLila Bergan on July 14, 2008
In our previous post entitled, "What is a Cataract?", we discussed the basics of cataract surgery. As we mentioned before, after removing the cataract from the eye, a soft plastic (silicon or acrylic) lens is placed in the eye behind the pupil in order to correct the vision. In this post, we will discuss different lens implants that are available.
The first lens implants were placed experimentally in the 1950's, but intraocular lens implants (IOLs) were not routinely used until the late 1970's or early 1980's. Before lens implants were placed, the patient was given thick "coke-bottle" glasses or a contact lens after his or her cataract surgery. Essentially, the patient was blind without these glasses. With improvements in the technology of the lenses, many patients are now able to see very well without glasses following cataract surgery.
There are many different lenses available, but these can be broken down into monofocal or bifocal lenses. Monofocal lenses are able to give the patient very good vision, but only at one distance. These are usually used to give the patient far vision, meaning that distance can be seen without glasses, but reading glasses would be needed for near tasks. These lenses could also be placed in order to have good reading vision, but in that case, the distance would be blurry. The only way to have both distance and reading vision with monofocal lenses is to have one eye made for distance and one for near. This is called "monovision". Most patients that have monofocal IOLs will need to wear glasses at least part of the time.
Your doctor may also tell you that you have "astigmatism", which is a condition where the front of the eye, the cornea, is misshapen -- more oblong like a football than round like a basketball. There are now monofocal IOLs for astigmatism to give you the best vision possible. These astigmatism IOLs cost more than regular monofocal IOLs and are not completely covered by Medicare or other insurances.
Bifocal IOLs have the ability to give good vision at several different distances. There are several different types available (Crystalens, ReStor, ReZoom) with more on the way. These lenses work in different ways to give vision at different distances and all have their strengths and weaknesses. Some lenses are better at mid-range (computer) distance than they are up close, and some are better up close than at mid-range. Some give distortion, especially noticed at night with headlights, some do not. These can sometimes be mixed, putting one type in one eye and one type in the other, depending on the patient's visual needs. If considering bifocal implants, you would need to consult with your doctor about your activities and visual needs. Most patients who have bifocal implants placed in both eyes will not need to wear glasses, although there are some patients who will need them for certain tasks. Another disadvantage to bifocal implants is that Medicare and other insurances do not cover the added expense of these new technologies, which can cost $1500-$2500 per eye, depending on your surgeon's fees.
Dr. Snook and his partners, Drs. Stephen Ku and Stephen Elieff, are ophthalmologists at North Dallas Eye Associates, with offices in Denton, Lewisville and Plano, Texas. They have a full-service practice offering regular eye exams for glasses, as well as diagnosis and treatment of eye diseases such as cataract, glaucoma and macular degeneration. For more information on Dr. Snook and his practice, please see the Medical Specialists/Physicians/Eye and Ophthalmology section of our web site.
