Cataract Replacement Lenses: You Have Choices

You’ll need the guidance of your eye surgeon, of course, but there are different cataract replacement lenses that do varying things to your vision--and to your wallet.

cataract replacement lenses

According to the National Eye Institute by age 80, more than half of all Americans either have a cataract or have had cataract surgery.

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The type of cataract replacement lenses you need after cataract surgery depends largely on your lifestyle and visual requirements. You may also have to weigh the costs of various cataract replacement lenses because the newer “premium” lenses come with higher out-of-pocket expenses.

Remember, during cataract surgery, the lenses of your eyes are removed. Usually, cataract replacement lenses are surgically implanted in your eye to take its place. Your eye surgeon should discuss cataract replacement lenses with you before the surgery. In fact, it’s so important, that if he or she doesn’t ask you about cataract replacement lenses, you should raise the question yourself.

Before cataract surgery, you’ll have tests to measure different aspects of the eye, like degree or nearsightedness or farsightedness, the curve of the corneas, and the length of your eye. This information will help you and the doctor to choose the appropriate lens implant to provide the best vision possible after your cataract procedure.

Types of Cataract replacement Lenses

Monofocal: This is the standard-option cataract replacement lenses and the least expensive. They are covered by Medicare. These implants provide clear distance or near vision, but not both. Many people choose the option of clear distance vision but use glasses for near-vision tasks. Other people prefer to be able to read and socialize without corrective lenses, but don’t mind using them for driving and out-of-doors activities.

As with contact lenses, you may be given the option of a monovision correction with monofocal implants by having one implant set for distance and the other for near vision and reading. Monofocal implants are usually a covered insurance benefit.

However, cataract surgery can result in astigmatism that requires correction. For example, it can cause the cornea to become unevenly shaped. Toric monofocal lenses can correct astigmatism. People who have toric lens implants are more likely to be free of wearing glasses for distance vision compared to people who receive conventional intraocular lenses, according to a recent study. In that study, which included 86 individuals with at least 1.25 diopters of bilateral corneal astigmatism, 70 percent ended up with uncorrected vision of at least 20/25, compared to 31 percent in the control group.

Additionally, multifocal and accommodating intraocular lenses are now available, which provide both near and distance vision. They essentially correct for presbyopia, the inability of the aging eye to change shape to provide distance and near vision as needed.

Multifocal: These premium cataract replacement lenses use advanced optics to provide maximum range of clear vision across varying distances and lighting conditions. For some people, multifocal lenses reduce or eliminate the need for reading glasses. As many as 90 percent of patients report high levels of satisfaction with implanted multifocal lenses. In exchange for these benefits, however, a small percentage of people experience problems with glare and halo effects.

Accommodative: These presbyopia-correcting cataract replacement lenses are designed to move forward and backward slightly in response to the eye’s natural focusing muscles. This provides a greater range of vision correction than monovision, with more freedom from having to use eyeglasses. Accommodative lenses potentially provide better distance vision than do multifocals, you may still sometimes need to use reading glasses for up-close visual tasks. A variation of these lenses, called “dual optic” accommodating intraocular lenses, may improve visual contrast in low light compared to older multifocal lenses. This technology incorporates two different lenses in one implant.

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