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Cataract Surgery Lens Options | Eduardo Besser, MD


 

Dr Besser will help you choose the best intraocular lenses for your vision needs.

Which Lens Is Best For Cataract Surgery Replacement?

When you decide to have cataract eye surgery, you need to choose which type of  intraocular lens (IOL) will be implanted in your eye, and whether you want a high-performance implant option that can reduce or eliminate your need for glasses.

 

During your consultation, Dr. Besser will help you decide on a standard monofocal lens, or a premium presbyopia-correcting lens, of which there are several types. Standard monofocal lens implants correct for one vision range only, near or far. Patients will need eyeglasses for the range not chosen. 

 

Presbyopia-correcting lens implants can correct for distance, intermediate, and/or near ranges. Currently, the three leading cataract lens technologies are:

 

  • Multifocal - the PanOptix Trifocal Intraocular lens
  • Extended depth-of-focus - the Symfony EDOF lens + Vivity intraocular lens
  • Accommodative - the Crystalens Accommodative lens

 

If you have astigmatism and you want to correct it with surgery, you’d require a special toric version of one of these cataract lens options.

 

 

What Are The Different Types Of Lenses For Cataract Surgery?

As described above, presbyopia causes a loss of lens flexibility, resulting in an inability to shift our visual focus from, say, the TV across the room to a book on our lap. 

 

A standard monofocal cataract lens option provides the best possible vision following surgery, without the need to wear glasses at one of those distances– the tv, or the book. Most monofocal lens patients opt for glasses-free distance vision, understanding that they’ll still need reading glasses to see up close after vision correction surgery. 

 

If you have astigmatism, you’ll likely require glasses both for distance and near.

 

By contrast, specialized presbyopia-correcting IOLs enable people to see clearly at multiple distances: distance (driving, watching television), intermediate (computer, tablet), and/or near (reading). They can also correct for astigmatism.

Four Factors In Choosing a Cataract Lens

No single cataract lens is best for everyone. There are multiple presbyopia-correcting IOL technologies, and they have significant differences. To choose the right option for your cataract removal surgery, you need to consider four important factors: 

 

  • desired range of vision
  • whether astigmatism correction is required
  • cost
  • presence of any ocular diseases

 

1. Desired Range Of Vision

When selecting which cataract lens meets your needs, we strive to understand patient goals regarding the ranges of vision they want to maximize. These are far distance, mid-range, and/or close up vision. We discuss possibilities for eliminating the need for glasses at one or all ranges..

 

Think about the lifestyle activities that are most important to you. Are you an avid surfer, birdwatcher, theater lover? These activities rely on the ability to see clearly from afar, so distance vision is important to you. 

 

Does your work require spending hours in front of a computer or tablet each day? This means that enhanced mid-range vision is a priority. 

 

Are you a tattoo artist, voracious reader, jewelry maker? If so, you need to see clearly up close, so you’ll focus on maximizing your near vision.

 

2. Is Astigmatism a Factor?

 Astigmatism is an ophthalmic condition in which the cornea is somewhat oval-shaped rather than round. Astigmatism requires a specific type of IOL called a toric lens to allow clear vision without glasses or contacts after surgery.  

 

If you have astigmatism, a monofocal toric lens will correct for one vision range only. You can choose near or far, but you’ll still need glasses for the other range. Conversely, a presbyopia toric lens can correct for both near and far vision, enabling you to see clearly without glasses. It will also correct your astigmatism. 

 

All the presbyopia-correcting specialty lenses described below are available in toric versions.

 

3. Consider Cost

Monofocal (single-focus) lens options come standard with cataract surgery and are covered by insurance. Toric, multifocal and accommodative lenses, on the other hand, are high-performance upgrades. Most insurance companies won’t cover the cost of a specialty cataract lens. 

 

However, it’s worth considering that a pair of prescription glasses can cost anywhere from $300 to $1000. A multifocal implant costs more upfront, but may be more price-effective over time. They are designed to last for the rest of your life.

 

4. Do I have Any Ocular Diseases? 

Some lenses may be contraindicated if you have certain eye conditions, such as diabetic retinopathy or macular degeneration. This is something we’ll discuss thoroughly before your surgery during your cataract consultation and account for in your plan.

 

High-Performance IOLs

The four leading presbyopia-correcting lenses are:

 

- PanOptix Trifocal Intraocular Lens (made by Alcon)

- Vivity Extended Vision IOL (Alcon)

- Symfony Extended Depth-of-Focus Lens (Johnson & Johnson)

- CrystaLens Accommodative lens (Bausch & Lomb)

 

Alcon’s PanOptix Trifocal Intraocular Lens provides clear vision at all three visual ranges, offering patients independence from glasses. This lens can also correct astigmatism, but is contraindicated for certain eye diseases like macular degeneration.

 

Alcon’s Vivity Extended Vision IOL increases depth of field, providing clear vision at both middle and distance ranges, with continuous transitions rather than the separate focal points of a multifocal lens. It can be a better option than multifocals for patients with certain ocular conditions. 

 

Johnson & Johnson’s Symfony Lens provides an excellent field of vision for far-distance and intermediate ranges, and can also correct for astigmatism. Patients who opt for this lens occasionally need glasses for reading up close. 

 

Bausch & Lomb’s CrystaLens is also called an accommodative intraocular lens. This type of lens allows you to see distance and intermediate ranges. For certain eye diseases such as macular degeneration, the CrystaLens can be a better option. 

 

To learn more about cataract technology and the best lens option for you, or to schedule a consultation to find out if you’re a candidate for cataract surgery, contact our offices today.

310-838-0202

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Eduardo Besser, MD
9808 Venice Boulevard, Suite 400
Culver City, CA 90232
Phone: 310-838-0202
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