Cataract Implants
June 22, 2020 | by Karen E. Bhaskar MD

A cataract is the natural lens inside your eye that has become cloudy. During cataract surgery the cloudy natural lens is removed and replaced with a clear lens implant. There are three basic types of lens implants. Your eye surgeon will discuss the lens implant choices with you and let you know which ones you are a candidate for. You will then choose which lens fits your needs and budget.

TYPE 1: The Conventional (Monofocal) Lens

The conventional (monofocal) lens corrects farsightedness or nearsightedness so patients can see clearly at one of the three focal points in life without glasses: distance (such as driving and TV vision), intermediate (such as computer and music vision), and near (such as reading and sewing vision) provided they do not have astigmatism in their cornea. Patients who choose the monofocal lens for both eyes focused for distance (the most common choice) can expect to be independent of glasses for distance focusing but will need glasses for Intermediate and near tasks. Medicare and most other health insurance companies cover the monofocal lens. For patients who have experienced monovision before surgery, it can be an option with the monofocal lens.

TYPE 2: The Astigmatism-Correcting (Toric) Lens

Astigmatism, like farsightedness and nearsightedness, is also a focusing problem, however the error is concentrated more in one direction. People with astigmatism are usually farsighted or nearsighted too. For patients with astigmatism who want to be more independent of glasses, the astigmatism-correcting (toric) lens corrects farsightedness or nearsightedness along with the astigmatism, so they can see clearly at one of the three focal points in life without glasses. Patients who choose the toric lens for both eyes focused for distance (the most common choice) will increase their chances of seeing at distance without glasses but will still need glasses for Intermediate and near tasks. Medicare pays for a small portion of the toric lens, but there is additional out-of-pocket expense. Monovision is also an option with the toric lens.

TYPE 3: The Presbyopia-Correcting (Multifocal) Lens

Presbyopia is when the eye loses its ability to shift focus from distance to intermediate/near. It begins around the age of 40 and becomes progressively worse, stabilizing around the age of 60. People wear reading glasses or bifocals to correct presbyopia. The presbyopia-correcting (multifocal) lens attempts to correct patients’ eyes so they can see clearly at distance and intermediate/near without glasses. It is available in an astigmatism-correcting (toric) version for patients with astigmatism. Most patients who have the multifocal lens implanted are independent of glasses for distance and intermediate/near. There are some drawbacks to the multifocal lens including the need for reading glasses for fine print especially in low light situations, the observance of glare/halos around lights (different from the bothersome cataract glare), and a compromise to the quality of vision for the benefit of being independent of glasses. Newer multifocal lens models have significantly improved in these areas. A period of “neuro-adaptation” between three months to a year is common during which the patient adjusts to the multifocal lens, and some of the drawbacks of the lens (such as the observance of glare/halos) become less noticeable. Medicare pays for a small portion of the multifocal lens, but there is additional out-of-pocket expense. For best results with the multifocal lens, both eyes should be free of certain eye conditions that reduce eyesight.

Monovision

Monovision is when one of a patient’s eyes is focused for distance and the other for intermediate/near. Patients who have successfully experienced monovision before surgery, either naturally or with contact lenses, can opt for their eyes to be focused this way after cataract surgery with the monofocal or toric lens implants.

It’s very important that you discuss these options with your ophthalmologist so that together you can choose the best lens implant for your eyes. To schedule an appointment with Dr. Bhaskar, call 206-860-4550

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