Tell Me About My Options for Vision Correction With Cataract Surgery - Pt. 2
Are you a good candidate for a premium lens?
Although everyone wants the highest and best technology for their cataract surgery, premium or presbyopia-correcting intraocular lenses are not right for everyone. Each of the following should be considered when determining whether a premium lens is right for you.
The health of your eye:
Excellent vision requires a perfectly healthy eye. If you have eye diseases other than a cataract, a multifocal presbyopia-correcting lens may not be right for you. Eye diseases that could cause problems with a multifocal lens include advanced glaucoma, diabetic retinopathy, diabetic macular edema, or macular degeneration.
Astigmatism:
The cornea is the clear front window of your eye. It is normally perfectly smooth and round like a basketball. In some cases the shape of the cornea is slightly oval leading to a curvature like a football or spoon. This corneal shape is known as astigmatism. Because the Crystalens, ReStor, and ReZoom lenses do not currently treat astigmatism, patients with a significant amount of astigmatism are not good candidates for these lens options. To treat people with mild or moderate astigmatism your surgeon can make incisions in the cornea (Limbal Relaxing Incisions) that help change the shape and curvature of the cornea leading to better vision after the surgery. Astigmatism correcting lenses (toric lens) are also available for patients with astigmatism interested in seeing better without glasses.
Visual needs:
Presbyopia-correcting lenses are designed to provide an improved range of visual clarity at different distances. Because they are man-made lenses, minor imperfections in the optical properties of the lens exist, leading to decreased contrast sensitivity, glare, or halos under certain circumstances. Some patients function extremely well with these lenses and rarely notice negative visual effects from the lens. Other patients can be extremely bothered by even small visual symptoms. For example, an architect who is used to excellent vision and requires perfect clarity at near for working on detailed drawings and plans may be dissatisfied with the level of clarity given by a presbyopia-correcting lens. On the other hand, an active person in their 70’s who would like to be able to golf, view their score card without putting on reading glasses, and easily read the price tag on the new golf club in the pro shop is likely to be very pleased with their surgical outcome.
Motivated to not wear glasses:
Many patients consider cataract surgery an excellent opportunity to get rid of the glasses they have worn for many years. Other patients are so used to wearing glasses that they would feel naked or uncomfortable without them. Premium lenses are designed for patients who would like to put their glasses on the shelf and use them as little as possible. If you enjoy wearing glasses, or would be uncomfortable without them, the extra cost of a premium lens would not be a wise expenditure for you.
Your expectations going into the surgery will be closely related to your satisfaction after the cataract surgery with a premium lens implant. You should consider that a premium lens is designed to decrease the amount of time spent wearing glasses during the day. You should not expect that glasses will never be required, as there will be situations where you will need or want glasses to achieve perfect clarity and comfort during certain visual tasks.
The Pro’s and Con’s
Every option has possible benefits and some negatives. The benefit of new lens technology is to improve the clarity and quality of your vision at one or more distances. A few points to consider...
- Unfortunately these lenses can’t be “tried out” to see if you like them, or compared one lens type against another. You won’t know the full benefit of the lens you choose until it is implanted in your eye. Even your eye surgeon can’t directly compare the lenses – they have to rely on their clinical experience and the information given them by the lens manufacturer to help decide which is the best lens option for you.
- Once implanted the lens is generally not removed. Some patients who are having a difficult time deciding which lens is best for them ask if they can have a standard lens now and change to a premium lens later on. Because of safety issues, once a lens is implanted it is left there unless there is a medical reason to have it removed. Therefore, you must decide which lens you would like before your surgery.
Summary:
You may be a good candidate for a premium or presbyopia-correcting lens if you…
- Have a healthy eye (other than cataract of course)
- Have minimal astigmatism
- Are willing to adapt to minor visual effects such as glare or halos
- Are motivated to get rid of your glasses (or at least be able to use them less)
- Do not have expectations of perfect crisp vision at all distances
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