What is an Advanced Technology IOL?
When a person has cataract surgery, the natural lens in the eye is removed and replaced with a man-made lens (IOL). A cataract is a clouding of the natural lens that occurs with age, and replacing the cloudy lens with a clear lens gives clearer vision. There are many different types of IOLs available. A standard IOL will give clear vision, but generally glasses are still needed to see near and /or far. With Advanced Technology IOLs, also known as Premium IOLs, we can often reduce or eliminate dependence on glasses or contact lenses.
Advanced Technology Lens Implant Options
These lens implants correct astigmatism in the patient’s eye. Many people have a cornea that is not perfectly spherical in shape. This asymmetric curvature is called astigmatism. Astigmatism can be corrected in glasses, contact lenses, or in the eye itself with a Toric IOL. When cataract surgery is performed, measurements before surgery will determine how much astigmatism is in the surface of your eye (the cornea). This may not be at all the same as what is in your pre-surgical glasses or contact lenses. If you have significant astigmatism, and you prefer not to be dependent on glasses/contacts, a Toric IOL will correct the astigmatism and provide clear vision at either distance or near. Toric IOLs are not multifocal, so they have to be set for a particular type of vision without glasses (near vision or distance vision clear without glasses). Often we will set one eye for distance and the other for near, so that the patient can see both far and near without glasses—this is called monovision. Click here for more information on Toric IOLs and a video. There are also lenses that do correct astigmatism and also offer some near/far range of focus. Please see below: Restor Multifocal and Extended Range IOLs.
Multifocal (bifocal) IOLs (Tecnis multifocal or Restor multifocal)
These lenses provide good uncorrected near and distance vision. With this IOL in both eyes a patient usually does not need glasses most of the time. There are rings of different power in the lens so that both near and far vision are in focus. Both the Tecnis and the Restor Multifocal IOLs have been widely used for many years with excellent results. The Restor Multifocal can now provide astigmatism correction (Restor Toric Multifocal). Please click on either option above.
Accommodating IOLs (Crystalens IOL)
These lenses also provide near and far vision by flexing and slightly shifting in the eye when you shift from near to far viewing or visa versa. We find these lenses give a much better range of focus than a standard IOL, but the near vision is not always great for reading and readers may be needed. Nonetheless, we still use this type of IOL for patients who want to have a range of focus but are not good candidates for a multifocal IOL (we don’t recommend the multifocal IOLs in patients with macular disease such as macular degeneration, macular pucker, etc.).
Extended Range IOLs
The Tecnis Symfony IOL is a newer type of lens implant called Extended Range IOLs. These lenses are designed to have some of the advantages of multifocal IOLs without the disadvantages of a multifocal. The Tecnis Symfony IOL provides good distance and intermediate vision without glasses, but patients may still need glasses for reading. This lens can cause some glare and halos with night driving, but less so than with a multifocal IOL, and generally this is very mild. While multifocal IOLs can create a slight loss of contrast acuity, the Tecnis Symfony compares to the standard monofocal IOL in contrast sensitivity. In addition, the Symfony is available as Symfony Toric to correct mild to moderate amounts of astigmatism. The Tecnis Symfony is an excellent choice for a patient wishing to be more independent of glasses, especially if the patient has some astigmatism or concerns about glare.
Trifocal IOLs (PanOptix®)
PanOptix® Trifocal Lens, the first and only trifocal lens available in the United States. The AcrySof® IQ PanOptix® Trifocal IOL is a type of multifocal IOL used to focus images clearly onto the back of your eye (retina) to allow clear vision after the cataract removal. In addition, the center of the AcrySof® IQ PanOptix® Trifocal IOL allows for better near (reading) vision and intermediate (computer work) vision versus what a monofocal lens would provide while retaining the ability to distance vision. In addition, this lens is available with astigmatism correction (Toric) which addresses the asymmetric curvature of the cornea that impacts how images are focused on the back of the eye in affected individuals. As with other multifocal lenses, the PanOptix®’s multi-ring design can cause visual disturbances such as glare, rings around lights, starbursts (rays around light sources), and reduced contrast sensitivity (decrease in ability to distinguish objects from their background, especially in dim lighting) as compared to a standard IOL.
There is a chance that you still may need glasses for distance, intermediate, and/or near vision. You will get the full benefit of the AcrySof® IQ PanOptix® Trifocal IOL when it is placed in both eyes.
How does an Intraocular Lens (IOL) Work?
An IOL has a prescription built into it, much like the lens in your glasses or contact lens. Special measurements of your eye are taken before surgery to help us determine the power of the IOL needed for your specific eye. The IOL, once in place in the eye, then focuses light on the retina, giving you a clear image.
How Long is Cataract Surgery?
Generally cataract surgery takes 10-15 minutes. You will usually be at the surgicenter or hospital about 2 to 3 hours. During this time paperwork is filled out, dilating drops are administered, the staff will recheck your medical history, and you will be kept about a half-hour after the procedure to make sure you are feeling well and all of your instructions are clear.
Are there any Risks Associated with Advanced Technology IOL’s?
The general procedure for cataract removal and IOL insertion is the same regardless of the type of lens used, so for the most part the risk is not different. With a Toric IOL or limbal relaxing incisions to correct astigmatism, there is a risk of placing the IOL or the relaxing incision in the wrong position, which could actually increase the astigmatism in the eye. Our practice uses the VERION ™ Image Guided System to allow for the most accurate correction of astigmatism. This system images the eye in the office and then electronically transfers the patient’s unique imaging data to the operating room laser and microscope. This allows for the most precise placement of astigmatism correcting lens or relaxing incisions. While we have never had to reposition a Toric IOL, this could be done in a second trip to the operating room within a couple weeks of surgery if needed to correct such a problem.
With multifocal IOL’s some patients have glare with night driving after surgery. This is generally mild and tends to dissipate over several months. Even when patients have some glare, most feel that the benefits of this lens allowing them to see near and far without glasses outweighs the mild glare symptoms. There is also a slight loss in contrast sensitivity with multifocal IOLs. Most patients do not notice this.
For more detailed information on cataracts, cataract surgery, and different types of lens implants please select a topic below: