Customized Refractive Cataract Surgery 

Modern cataract surgery is lens replacement surgery. The eye’s natural, aged, and cloudy lens, called a cataract, is removed and replaced with a new crystal-clear manmade lens implant called an intraocular lens (IOL). The new implant restores the clarity of the optical system resulting in improved vision. The standard implant, covered by Medicare/Insurance, is a single-focus (mono-focal) IOL, which can result in good quality vision, but requires glasses or bifocals most of the time. Cataract surgery has become more sophisticated with advanced Elective IOLs. You now have the opportunity to choose a customized procedure of enhanced quality of vision and more independence from glasses. Medicare and other private insurance companies do not cover these elective services, requiring you to pay out-of-pocket for such an upgrade.

We divide vision into three zones:

-       Distance vision (watching TV, driving)

-       Intermediate vision (using computer, cooking)

-       Near vision (reading, up close work)

STANDARD IOL

MONOFOCAL IOL – a single focus lens implant

The traditional and basic monofocal IOL is a single-focus lens. This IOL only allows the eye to focus in one of the three zones, typically distance (but near or intermediate is an option for some patients). Glasses or bifocals are then used to bring the other zones into focus.

ELECTIVE IOLs

TORIC IOL – astigmatism-correcting single focus lens implant

Astigmatism is a common condition of the eye that causes blurry vision unless it is corrected with glasses or contact lenses. Until recently, glasses were prescribed after cataract surgery to correct any pre-existing astigmatism. Now, we can permanently correct astigmatism at the time of cataract surgery with a Toric IOL. This astigmatism-correcting lens upgrade allows an eye with astigmatism to achieve clearer single-focus vision with significantly less dependence on glasses. While Toric IOLs treat higher levels of astigmatism, corneal incisions with a diamond blade can treat low levels of astigmatism.

MULTIFOCAL/EXTENDED DEPTH OF FOCUS IOLs – Bifocal lens implants

These IOLs are made of the same material as the standard single-focus IOLs but provide an extended range of vision allowing the eye to focus at both distance and near. These lenses are also available in toric designs (multifocal/toric and EDOF/toric IOLs) to simultaneously correct pre-existing astigmatism. This greatly reduces the need for glasses after cataract surgery. Any lens implant may cause glare or halos around lights, particularly at night. Multifocal IOLs have more tendency to do so because of their design which divides light coming into the eye into 3 separate focal points. This side effect is not bothersome to most people and usually fades with time. The PanOptix trifocal IOL typically provides excellent distance and near vision while computer glasses for intermediate vision may be needed. The Vivity IOL typically provides excellent distance and intermediate vision while reading glasses for near vision may be needed.

Your ophthalmologist will evaluate your eyes to see if you are a candidate for any of the advanced Elective IOL options.