Intraocular lenses, (also know as “IOLs”), are the artificial lenses that we implant on the inside the eye to replace the optical power of the natural lens that is removed during cataract surgery. In 1981 the FDA approved the first IOL for use in the US. Prior to then, there were no artificial lenses available to put back on inside the eye when the natural lens was removed. In order to see clearly, and make up for the lost optical power, people had to wear very thick glasses or wear special contacts after surgery.
Recently, many types of IOLs have been introduced to help with many types of vision problems, and now, more than ever, patients are becoming more involved in selecting the type of IOL that might best suit their needs.
The following is meant to be a simple guide to help you when you and your doctor are selecting the type of IOL that may be most appropriate for your needs. It is not and exhaustive list of IOLs, nor does it include an exhaustive list of advantages, disadvantages, risks and or benefits of each IOL or for cataract surgery in general. For further information please talk with your surgeon at Kitsap Eye Physicians.
Traditional IOLs are monofocal, meaning they can provide sharp vision within one certain range (far, intermediate, or near). Typically, people with this type of IOL will need reading glasses or bifocals to meet some of their visual needs.
Toric IOLs are designed to reduce higher levels of astigmatism. These lenses must be rotated into the proper axis during surgery. This does not always fully reduce the need for glasses after cataract surgery.
Multifocal and accommodating IOLs can help provide good vision for distance and near, reducing ones dependence on glasses. Some patients still require glasses for some activities.
Lower amounts of astigmatism can be treated with limbal relaxing incisions (LRI), which involves making incisions in the peripheral cornea. Higher levels of astigmatism often require the use of toric IOLs, possibly with additional incisional techniques, to reduce astigmatism.
Monovision involves implanting an IOL in one eye to provide near vision and an IOL in the other eye to provide distance vision. A few people may have trouble adjusting, but usually people can adapt with time. If you are unable to adjust, you will need to correct the imbalance with glasses or contacts. Some patients feel that their fine depth perception is decreased when not wearing glasses because there is less binocular vision. Having monovision does not give full independence of glasses, but does provide the probability of good vision without total dependence on visual aids for most activities.
The cost of cataract surgery and the implantation of a traditional IOL are typically covered by most insurance plans including Medicare. However, the cost of many newer technology implants, the cost of some of the additional testing and procedures unique to their implantation, as well as most astigmatism procedures are not currently covered. Since the benefits of many newer IOLs are not felt to be medically necessary by insurance companies, they do not cover the additional costs associated with their implantation. The patient is responsible for the difference, which could be anywhere from $250 to $2,500 depending on the IOL or procedure.