Lens Implants

LensesModern medicine has made great advances in cataract surgery. Today millions of people every year undergo this vision improving procedure with excellent results. In addition to the advances in cataract surgery there has been huge advances in intraocular lens technology. The intraocular lens (IOL) is a lens that is put into your eye to replace the cataract that has been removed. This lens is necessary to be able to focus light adequately on the retina. With the number of new lenses and improvements in technology cataract surgery has become refractive in nature. The new lenses offer great opportunities for improvement in visual clarity, contrast sensitivity and a greater chance of spectacle freedom following surgery. A consultation with Dr. Anderson will help you determine the best lens for you.

The costs of cataract surgery and IOL implantation are covered by the Medical Service Plan (MSP). However, each of the IOL options have additional costs associated with them based on the IOL type and pre-operative, analysis and calcuations performed that are not covered by MSP and you will be responsible for covering the costs associated with the lens option you have chosen. If you have private/third party health insurance, you may be able to claim some or all of these costs.

Pre-operative Intraocular lens (IOL) Testing

Only basic IOL testing is covered by MSP. In order to allow Dr. Anderson to customize the IOL model and power for the specific characteristics of your eye, and thus provide you with the best possible outcome, two additional pre-operative tests must be performed. These two tests are called Laser Optical Biometry and Corneal Topography. The cost of these two tests is not covered by MSP. If you have private/third party insurance you should check with them, as you may be able to claim some or all of these costs depending on your plan.

1. Laser Optical Biometry

This is the most sophisticated and accurate test available to determine the power of the IOL needed by safely and precisely measuring the length, surface, curvature and depth of the cataract in the eye. A more accurate IOL power measurement allows for significantly clearer vision after surgery, often without the need for glasses for either far of close vision. Optimized IOL powere accuracy also greatly improves the balance of vision between the two eyes in patients that will undergo surgery to both eyes.

2. Corneal Topography

This test produces a highly detailed, three dimensional map of the cornea (the clear window at the front of the eye:. This test not only provides a second surface curvature measurement (helping with IOL poweraccuracy), but it also measures spherical aberration, which is essential for proper IOL model selection. Spherical aberration is a natural optical phenomenon of the eye that, if uncorrected, leads to blurred vision and reduced contrast sensitivity. Fortunately, all modern-day IOLs can correct spherical aberration, but each model differs in the specific amount of correction it provides. The Corneal Topography test is necessary to measure the spherical aberration of your eye, allowing Dr. Anderson to select the IOL model that will best correct the spherical aberration in your eye. This will provide improved night vision, improved vision in rainly, foggy and snowy weather, less risk of glare and halos, and even safer driving abilty following surgery. In fact, a study demonstrated that drivers with IOL implants containing the proper spherical correction were able to stop their cars 67 feet sooner when driving at night compared with those drivers with IOL implants with no spherical aberration correction.

There are currenty three different Intraocular lens (IOL) options available:

Standard Aspheric IOL
The aspheric foldable IOL represents another advancement in lens technology. Although today most intraocular lenses such as the standard foldable lens provide good vision to the patient, the image quality it provided was not always perfect. Various visual symptoms such as halos, glare, or reduced contrast could occur. This is the result of what we call optical aberrations. The aspheric lens corrects for these optical aberrations to give you a clearer and sharper image. It also increases contrast sensitivity in varying light conditions and will generally improve vision quality. In particular, the Alcon AcrySoft Image Quality Lens mimics the light filtration properties of the natural crystalline lens, by filtering both UV and blue light. There is theoretical evidence to indicate that filtering the blue light may decrease the risk or progression of age related macular degeneration.

Toric IOL
The Toric lens was developed to correct corneal astigmatism. Not every patient will benefit from the toric lens. It is only recommended for those who have pre-existing astigmatism. When the surface of the cornea has an uneven curvature vision becomes distorted. This common irregularity called corneal astigmatism, causes blurred or distorted vision, because the light rays are not focused on one spot to provide clear vision. The AcrySoft Toric intraocular lens makes it possible to replace the cataract and correct the corneal astigmatism at the same time. Its unique design reduces or eliminates corneal astigmatism and significantly improves uncorrected distance vision. This lens provides quality distance vision, independent of eye glasses or contact lenses. The benefit of the toric intraocular lens is that it reduces or eliminates corneal astigmatism and is therefore only implanted in patients with pre-existing astigmatism. 97% of patients were spectacle independent for distance activities following bilateral implantation of this lens and it also mimics the light filtration properties of the natural crystalline lens by filtering both UV and blue light.

Multi-Focal IOL
Multi-focal IOLThe ReSTOR lens is a multifocal lens. This lens represents another technological advance as it now enables us to insert a lens that will correct you for distance and near vision simultaneously. The other lenses previously discussed will typically correct for distance vision but one would need to wear reading glasses to be able to read up close. The ReSTOR lens implanted bilaterally has a very good chance of decreasing your dependency on both distance and near spectacles. A recent study revealed that 80% of patients receiving the AcrySoft ReSTOR lens were able to perform daily tasks without wearing glasses compared to 5% of non ReSTOR or traditional foldable lens patients. The AcrySoft ReSTOR  IOL works in concert with the pupil to provide a quality range of vision in all lighting conditions. It also mimics the light filtration properties of the natural crystalline lens by filtering both UV and blue light.

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Carolyn Anderson MD

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