What is advanced technology intraocular lens (IOL) vision enhancement?
The advanced technology IOL is a new, state-of-the-art type of intraocular lens that can provide a full range of vision, from near to distance, in most patients. The procedure for removing the natural lens and implanting the advanced technology IOL is the same that’s been used for years in cataract surgery, but the result is a full range of vision, significantly reducing or eliminating the need for glasses or contact lenses.
What makes advanced technology IOLs different from ordinary intraocular lenses?
Unlike an ordinary IOL, the advanced technology IOL can focus on objects near and far. The crystalens® is designed to be focused by the eye’s natural muscle; the ReSTOR® lens has special surface design that brings near and distant objects into focus without muscle assistance. The ReZoom lens has multiple focusing zones on the surface of the lens implant. are intended to provide most patients a full range of vision without the need for corrective lenses. With ordinary IOLs, most people MUST rely on glasses or contact lenses for middle and near vision.
Do advanced technology IOLs provide 20/20 vision for both reading and distance?
Advanced technology IOLs were created to provide a full range of vision, near to distance. Nearly everyone will find their uncorrected vision significantly better after surgery, but some will not see 20/20 through the full range of vision.
Pre-existing ocular and physiological factors may prevent full range 20/20 vision. Your doctor will advise you of any conditions which may affect the outcome of your individual surgery. In FDA clinical studies of ReSTOR®, 80 percent of participants with replacement lenses in both eyes did not use glasses or contact lenses after the procedure; 84 percent achieved 20/25 or better distance vision and 20/30 or better near vision and could read small stock quotes in a newspaper.
Am I a good candidate for advanced technology IOL vision enhancement?
Only an experienced eye doctor can evaluate your vision care needs and recommend a customized course of treatment.
Most people in good general health are good candidates for advanced technology IOLs. Exceptions include those who have already had cataract surgery. Those who have had corneal refractive surgery may be good candidates, if approved by a doctor. They may require an enhancement procedure to achieve the best result. Those with uncontrolled diabetes, chronic infections, and certain other health problems should not have lens replacement surgery until these conditions are under control.
Will the doctor implant advanced technology IOLs in both eyes at the same time?
For the best result, advanced technology IOLs should be implanted in both eyes. Cataracts normally develop in both eyes at the same time. In the instance of only one clouded lens, only that lens needs to be replaced. For the typical patient, although both lenses need replacement, we prefer not to do them at the same time.
The normal procedure is to replace the lens that is most clouded first. If both are equally clouded, your doctor will usually replace the lens in the non-dominant eye first. The interval between surgeries depends on the healing of the first eye and the vision results; two to three weeks is typical.
How long does the procedure last? Is it painful?
The actual implanting of the advanced technology IOL takes about! 20 minutes; the whole visit to the surgical center usually takes less than two hours.
The patient arrives about an hour before the procedure and is given oral medication to induce relaxation and eye drops to anesthetize the eye and dilate the pupil.
Once the patient is on the surgical bed and the eyelid is secured, the old lens is removed and the replacement inserted through a tiny incision. There is a sensation of pressure on the eye, but no pain.
After surgery, more eye drops are applied to prevent infection, decrease inflammation, and keep the pupil dilated. A protective patch is usually placed over the eye. Once home, the patient should rest and avoid any strenuous activities. The doctor will examine the eye the next day and advise the patient on the appropriate course of recovery, which will include continuing eye drops for a week or two and avoiding strain on the eye until it is thoroughly healed.
Be sure to arrange for some one to drive you home after the procedure.
What is the likelihood of complications, and what might they be?
Advanced technology IOLs are revolutionary, because, unlike ordinary IOLs, they provide multifocal vision. They are also evolutionary, since the actual procedure for implantation is the same as the regular cataract lens replacement surgery, which has been practiced for decades. The basic procedure is performed on more than seven million eyes each year, and has proven extremely safe; however, there is always a chance of complication with even the most routine surgery.
Most complications, such as minor infections, inflammation, and irritation, are temporary and easily treated. Serious sight-threatening complications, such as serious infection, hemorrhaging, or retinal detachment, are extremely rare, but are more likely in patients with diabetes and high blood pressure, and those who suffer from chronic inflammation and infections. About 98 percent of cataract surgery patients experience no complications and more than 95 percent achieve improved vision.
As with all surgical procedures, the eye surgeon will perform a thorough examination and provide a complete evaluation of expected results and possible complications.
How does vision improve after surgery?
After surgery, vision improves gradually, as the eye first heals, then adapts to the advanced technology IOL. Distance will usually be very good within a day or two after surgery. With the ReSTOR® lens, you will see an improvement in near vision in usually the first several days, though some patients may take longer.
Implant surgery is intended to correct deficiencies in the eye’s lens, and will not help with vision problems related to other parts of the eye, such as floaters, flashes, or visual field loss.
This information is general and not intended to apply completely and specifically to any individual patient. Only a consultation with an experienced eye surgery professional can disclose all circumstances applicable to the individual patient.
The long-term safety and effectiveness of this lens has not been established.
Will lens implant surgery cause glare, night driving problems, and light sensitivity?
Glare, night driving problems, and light sensitivity can occur with both traditional and advanced technology lens implants. Night vision problems are usually much less severe than before cataract surgery. These phenomena are usually temporary and diminish as the brain and eyes adjust.
Light sensitivity is usually temporary. The crystal-clear material of the advanced technology IOL nearly always permits more light to pass through than the natural lens it replaces, so that some patients might have to adjust to seeing vivid colors and brighter lights than before surgery.
All intraocular lenses can produce glare, light flares, or a halo effect at night, since the pupil is open wider and allows light to reflect off the edge of the implant. Your doctor, through medication or night driving glasses, can usually compensate for these problems.
How soon after lens implant surgery will I be able to resume normal activities?
Most patients require only a few days to resume normal activities, with some limitations and adjustments. Some sensitivity to touch and bright lights should not deter most patients from driving and returning to work.
Patients may be given medication to prevent infection and control inflammation. A protective shield may be advisable while sleeping, and sunglasses can provide protection during the day.
For several days after surgery, patients should avoid any heavy lifting or straining the can increase pressure in the eye. Rubbing or pushing of the eye and any situation that could result in being hit in the eye are also to be avoided.
Careful showering and shampooing are permitted, as long as no soap or shampoo touches the eye. Any makeup around the eye should be avoided for several weeks. Public swimming pools, hot tubs, and other potential sources of bacterial contamination should also be avoided.
When in doubt, the patient should consult the doctor for guidelines regarding post-surgical activities.
How often do I need to have my eyes checked after surgery?
Your doctor will check your eyes the day after surgery, and, depending on your particular case, again after about two to four weeks,
and again after about three to six months. After that, annual eye exams are recommended, unless a specific problem develops.
Will I have to have cataract surgery again?
In cataract surgery, natural lenses are removed and replaced with artificial lenses, which are not subject to deterioration and should last a lifetime.
Some patients experience subsequent clouding of the membrane which holds the lens, called the capsular bag. The normal treatment for this is a capsulotomy, in which a laser beam is used to punch a hole through the membrane, allowing a clear path for light. It is a quick and painless procedure.
Is advanced technology IOL implantation covered by insurance?
Most private insurance covers the cataract surgical procedure and the anesthesia, but may cover only a portion of the cost of an advanced technology IOL, since it costs more and is considered non-standard.
Patients should consult with both the doctor and the insurance carrier to determine their best alternatives.