Intraocular lenses (IOLs) are medical devices that are implanted inside the eye to replace the eye’s natural lens when it is removed during cataract surgical treatment as it becomes cloudy with the natural ageing process. IOLs are also used for a sort of vision correction surgical procedure called refractive lens exchange (RLE).
Before making use of intraocular lenses, if you actually have had cataracts removed, you had to wear very thick glasses or customized contact lenses in order to see clearly after cataract surgery, since no tool was implanted in the eye to replace the focusing power of the natural lens.
Today there is a variety of types of IOLs to pick from. The best intraocular lens for you depends on several variables, including your lifestyle and your specific visual requirements, which are best assessed by a qualified eye doctor or ophthalmologist.
The following is a review of types of IOLs presently readily available. Usually in the past, you will generally be provided mono-focal lenses, which have a single point of focus. This implies that the lens will take care of either near or distance vision, but not both.
If you go premium, you will have the option to select from a wider option of IOLs and also during your preoperative exam and appointment, your cataract specialist can help you choose the very best IOL for your needs, but extra cataract surgery costs will entail if you choose among the following premium lens implants.
Conventional intraocular lenses have a spherical optical design, suggesting that the front surface is evenly curved from the centre of the lens to its perimeter. Though a round IOL is reasonably very easy to produce, this style does not simulate the shape of the all-natural lens inside the eye, which differs in curvature from centre to periphery. Simply put, the eye’s natural lens is aspheric (“not spherical”).
Why is this essential?
A round intraocular lens can cause minor optical imperfections called higher-order aberrations (HOAs), which can affect quality of vision, particularly in low-light tasks such as driving at night.
Premium aspheric IOLs, on the other hand, match exactly the shape and optical quality of the eye’s natural lens, as well as thus can offer sharper vision – particularly in reduced light conditions and also for people with large pupils.
Toric IOLs are superior intraocular lenses that correct astigmatism in addition to near-sightedness or long sightedness.
Like toric soft contact lenses, toric IOLs can correct astigmatism due to the fact that they have a range of powers in different meridians of the lens. They also have positioning markings on the outer part of the lens that allow the doctor to change the orientation of the IOL inside the eye for optimum astigmatism correction.
Simply before cataract surgery, the surgeon positions temporary markings on the patient’s cornea that recognize the area of the most rounded meridian of the front of the eye. Then, when the toric IOL is implanted during the cataract treatment, the surgeon turns the IOL so the markings on the IOL are aligned with the markings on the cornea to ensure appropriate astigmatism correction.
Prior to the advent of toric IOLs, cataract surgeons had to perform a procedure called limbal relaxing incisions (LRI) to correct astigmatism during or after cataract surgery.
In LRI, tiny cuts are made at opposite ends of the cornea, extremely near the junction in between the cornea and the surrounding white sclera. When these incisions heal, the cornea comes to be extra round in shape, reducing or getting rid of astigmatism.
In many cases – also when a toric IOL is made use of – limbal relaxing incisions might be needed after cataract surgery to completely correct astigmatism. Yet usually in such cases, the amount of astigmatism remaining after implantation of a toric IOL is much less, making a much better LRI outcome more likely, while not eliminating the need for an LRI completely.
LASIK as well as PRK can also be carried out after cataract surgical procedure to correct recurring astigmatism, yet toric IOLs decrease the likelihood of requiring these added surgical operations.
Traditional spherical IOLs are mono-focal lenses, suggesting they are developed to provide clear vision at a solitary focal point (generally far away driving vision, as an example). With conventional IOLs, normally you need to put on glasses or contact lenses in order to use a computer system, read or carry out various other near tasks within arm’s length, to help with your near vision correction.
Accommodating IOLs are unique intraocular lenses that increase the range of clear vision with both an aspheric design as well as adaptable “haptics” – the supporting legs that hold the IOL in place inside the eye.
These adaptable legs allow the accommodating IOL to move forward slightly when you see near objects, with the focusing unimpaired due to the change in your seeing range when you need to see up close as this increases the focusing power of the eye sufficiently enough to offer better near vision than a conventional mono-focal lens.
Accommodating IOLs might not provide the same level of zoom for near vision that a multifocal IOL does. However many people find these premium IOLs greatly lower their need for reading glasses or computer glasses after cataract surgery, while providing remarkably clear distance vision similar to that provided by a mono-focal IOL.
Multifocal IOLs are an additional classification of presbyopia-correcting IOLs that can reduce your need for reading glasses or computer system glasses after cataract surgical treatment.
Like multifocal contact lenses, these premium IOLs have added magnification in various parts of the lens to expand your range of vision so you can see things clearly at whatsoever distances without glasses or contact lenses.
Some research studies have shown multifocal IOLs often tend to provide better near vision than accommodating IOLs, but they are also more likely to cause glare or mildly obscured distance vision as a trade off, so you may not get the best of both worlds with utmost perfection.
Your cataract doctor can help you decide if you are a good prospect for multifocal IOLs at your preoperative consultation and examination.
Laser cataract surgical treatment is frequently recommended if you have an interest in multifocal IOLs, due to the fact that exact alignment of these lenses is very crucial to offer you the very best visual outcome at whatsoever distances.
An option to accommodating and multifocal IOLs for correcting presbyopia is monovision.
There is no such thing as a “monovision IOL.” Monovision is the method of fully fixing the refractive error of one eye and purposefully making the other eye slightly near sighted.
In this circumstance, the fully corrected eye sees far away things clearly (however cannot see very well up close without glasses), as well as the slightly near sighted eye sees extremely well up close without glasses (yet not so clearly far away).
Monovision may seem weird the very first time you become aware of it, but this technique has been utilized extremely effectively with contact lenses for several years. And also it is now being utilized often with cataract surgical treatment to reduce an individual’s dependence on reading glasses and computer system glasses after surgery.
Any combination of premium IOLs can be used for monovision cataract surgical procedure.
When accommodating or multifocal IOLs are utilized for monovision, the term “modified monovision” is often made use of, since these lenses use a broadened range of vision by nature of their design along with a prescribed monovision outcome.
A different IOL for each eye
In some cases, the most effective visual outcome after cataract surgical treatment is achieved by utilizing a different kind of premium IOL in each eye, which may sound strange but is explained in the following paragraphs.
For example, you may have much more astigmatism in one eye than the other. If this is the case, your cataract specialist may advise a toric IOL in that eye, as well as perhaps a accommodating IOL in the other eye to also lower your requirement for computer glasses.
Another situation is for your cataract surgeon to recommend one brand of multifocal lens for one eye and a different brand for the other. This is since one brand name may offer better computer vision and the other might provide sharper vision at a closer distance, for reading and also various other near tasks.
Your cataract surgeon can fully evaluate your detailed needs through your pre-op examination as well as consultation, and also help you pick the very best combination of premium IOLs for a successful visual outcome.
Cost of premium IOLs
Premium IOLs have extra functions not found in standard mono-focal IOLs and also set you back greater than conventional IOLs.
Unfortunately, some insurance providers do not consider these added attributes as medical necessities. Consequently, you will sustain added out-of-pocket expenses for your cataract surgical treatment if you pick a premium IOL.
To totally understand your cataract surgical procedure prices and also insurance coverage, read your insurance plan very carefully before you have surgical treatment. Additionally, ask a lot of cost-related questions to your optometrist and also cataract specialist prior to granting permission for surgery, to avoid undesirable financial shocks later.
READY TO SCHEDULE A CATARACT SURGERY? Find a cataract surgeon near you or consult us at Khanna Vision Institute, Westlake & Beverly Hills, CA.