For most of us, at about age 50, the crystalline lens of the eye begins to get cloudy as we develop cataracts. The only way to treat cataracts is surgery. During the procedure, your surgeon removes your cloudy natural lens and replaces it with a synthetic intraocular lens or IOL. This procedure is one of the most frequently performed medical procedures in the world today. The removal of the lens is usually accomplished using a gentle ultrasound. Once removed, your surgeon replaces it with an IOL.
In the past, most of the IOLs were monofocal with a fixed focusing power that is set for distant vision and glasses were required for reading. Today we can offer patients a choice of monofocal or presbyopia-correcting IOLs that improve both distance and near vision at the same time. Presbyopia-correcting IOLs come in two forms: multifocal and accommodative. Multifocal IOLs restore distance, intermediate and near vision to the aging eye using diffractive or refractive optics. Since a multifocal IOL can focus light from distance and near simultaneously it can make the recipient less dependent on glasses or contact lenses.
Are all multifocal IOLs the same?
There are two different types of multifocal lenses on the market today. The diffractive multifocal IOL the a refractive multifocal IOL both provide both distance and near vision. However, they each have their own set of advantages and disadvantages.
Patients like the diffractive multifocal IOLs because they provides great reading vision and very good distance vision. Most find the intermediate vision to be acceptable. However, those patients who do computer work may need to sit closer or make the font size larger. Some others prefer to wear intermediate vision glasses while at the computer. Some patients with diffractive IOLs complain of glare and haloes around lights at night while driving. Keep in mind that some patients implanted with monofocal IOLs also notice glare and halos.
Patients that have received a refractive multifocal lens implant report excellent intermediate and distance vision results. Their near vision generally adequate but have trouble with the small print in phone books, or warranty information. A pair of reading glasses can be helpful for those for near tasks that are difficult. In addition, 25% of patients note glare and haloes around lights at night with the refractive multifocal IOL, a feature that is inherent to multifocal lenses. Like the patients with diffractive IOLS, some patients with refractive multifocal IOLS complain of glare and haloes around lights at night while driving as do some patients implanted with monofocal IOLs also notice glare and halos.
How well will I see after my surgery?
Most patients with healthy eyes should be able to achieve 20/20 vision with glasses, contact lenses or refractive surgery such as LASIK, PRK, CK.
Will my insurance pay for multifocal IOLs?
Medicare and insurance will cover the cost of a your standard IOL. However, most insurances, including Medicare, will only pay for surgery and devices used to restore functional vision. They will not pay for any services that go beyond that to reduce dependence on glasses or contact lenses.
Will I need multifocal lenses in both eyes?
The current consensus is that when needed, a multifocal lens should be implanted in both eyes to maximize the full benefit of the technology.
How long is recovery?
It may take from a few weeks to a few months for your brain to adjust to your new artificial optical system. Patients say that their adaptation to their new vision becomes less noticeable as time goes on.