Artificial intraocular lenses, or IOLs, replace the eye’s natural lens that is removed during cataract surgery. IOLs have been around since the mid-1960s, though the first FDA approval for one occurred in 1981. Before that, if you had cataracts removed, you had to wear very thick eyeglasses or special contact lenses in order to see afterward, since the natural lens that had been removed wasn’t replaced with an artificial one.
Until recently, only cataract surgeons — not their patients — weighed the risks and benefits of various IOLs. The surgeons’ discussions focused on the surgical technique (clear cornea, small incision, etc.) and the physical design of the lenses (one-piece vs. multi-piece, acrylic vs. silicone) and how that design affected insertion, positioning and healing.
Good vision after cataract surgery was another important consideration. But now that new IOLs have been introduced that solve more vision problems than ever, cataract surgeons have more to consider before choosing IOLs for their patients’ visual needs. Cataract patients are becoming more involved in the choice as well.
If you or someone you know will be undergoing cataract surgery, consider your choices in the following summary of the most recently developed IOLs.
Premium IOLs: Multifocal & Accommodating
Traditional IOLs are monofocal, meaning they offer vision at one distance only (far, intermediate or near). They definitely are an improvement over the cataractous lens that is replaced during surgery, which provides only cloudy, blurred vision at any distance. But traditional IOLs mean that you must wear eyeglasses or contact lenses in order to read, use a computer or view objects at arm’s length.
The new multifocal IOL’s, the Symfony HD Multifocal, and Symfony Multifocal Toric offer the possibility of seeing well at more than one distance, without glasses or contacts. The toric IOL corrects for astigmatism.
Presbyopia or astigmatism correcting IOLs are considered “premium” lenses, which means that they are an upgrade from the standard IOL. Accordingly, there is an associated additional cost.
Because of the additional practical but not essential benefits of these IOLs, they are considered a cosmetic enhancement and not a medical necessity.
Medicare and most health care plans will cover the cost of the standard implant, so the patient is only responsible for the difference. Although there is an additional cost to these unique implants, the benefits are a permanent investment in vision. One gets the opportunity for this type of correction only once in a lifetime!