Lens Implant (IOL) Options

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All IOLs improve how well you can see with glasses after surgery; the specific type determines how well you will see without glasses.

 

Monofocal IOLs are the only IOLs covered and paid for by Medicare and insurance (subject to deductibles and co-insurance). Advanced technology IOLs (which can further reduce dependence on glasses after surgery) are NOT considered a medical necessity and, therefore, are NOT covered by medical, vision, or other insurances. With these IOLs, your insurance provides coverage for the surgery, however, you are responsible for the cost of the IOL itself and additional testing. Which type of IOL is best for you depends on your vision, lifestyle, eye anatomy, surgeon’s recommendations, expectations and budget. The following information offers brief descriptions of the main types of IOLs currently available.

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Monofocal Lens: Fixed Focus Capability          

The monofocal IOL is a fixed-focus implant. This means that: 

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• IF you DO NOT have a visually significant amount of astigmatism (an oval-shaped eye that distorts vision), the monofocal IOL provides clear vision without glasses at one fixed distance—either far away OR near, but NOT BOTH.

  • If your lens prescription is set for far (driving, watching TV, etc.), you will need glasses to see near.

  • If your lens prescription is set for near (reading, close tasks, etc.) or intermediate (computer work, etc.), you will need glasses to see far. 

  • If you have successfully used contact lenses for “monovision” (one lens prescription for near and the other for distance), cataract surgery can be done to achieve similar results.

  • No matter what the IOL prescription, there may still be a need to wear glasses to fine­-tune vision even at the targeted distance. 

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• If you DO have significant astigmatism, you will need glasses/bifocals to see clearly at ALL distances.
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Advanced Technology IOLs

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Toric:  Astigmatism-Correction Capability      

In addition to providing for clear vision near or far, the toric IOL includes a correction for astigmatism. Astigmatism is a condition in which the cornea is more oval­-shaped, like an egg, rather than round, like a normal eye. This causes images to appear blurry at all distances and is typically corrected with glasses or contact lenses. After cataract surgery, however, a toric IOL can help to achieve best vision either at near or far without glasses or contact lenses by correcting the astigmatism. 

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The monofocal toric IOL works at one fixed distance only. This means that:

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• If your lens prescription is set for far (driving, watching TV, etc.), you will need glasses to see near.

• If your lens prescription is set for near (reading, close tasks, etc.) or intermediate (computer work, etc.), you will need glasses to see far. 

• If you have successfully used contact lenses for “monovision” (one lens prescription for near and the other for distance), cataract surgery can be done to achieve similar results.

• No matter what the IOL prescription, there may still be a need to wear glasses to fine­-tune vision even at the targeted distance. 

• Toric IOLs have a small risk of rotating out of alignment within the first week after surgery. If this occurs, another surgical procedure may be required to reposition the lens​​

Multifocal & Extended Depth-of-Focus (EDOF):  Multiple Focus Capability

Unlike monofocal IOLs that provide your best vision at one fixed distance, multifocal and EDOF IOLs can allow you to function across multiple distances with a reduced need for glasses after surgery.  

 

Multifocal IOLs

• Provide improved ability to read fine print at a closer distance, compared to EDOF IOLs. 

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• ​Can cause halos and glare around light sources at night. These issues are typically mild and tolerable for most patients, but, rarely, some people require removal of their lens due to severe symptoms. 

EDOF IOLs 

• Typically provide good intermediate (computer distance) vision and excellent vision far away. Although near vision for close tasks is functional, some patients need or prefer to wear reading glasses for seeing fine print. 

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• Minimal added risk of glare, halos, or photopsias (perception of light) as compared to a basic monofocal IOL.

BOTH Multifocal & EDOF IOLs: 

• With both of these types of advanced technology lenses, there may still be a need to wear glasses to fine-­tune vision at various distances and in certain situations like low-light reading and/or driving at night.​

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• Both can also come with a built-in correction for patients with astigmatism (explained above).

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• If your multifocal or EDOF IOL also corrects for astigmatism, there is a small risk of it rotating out of alignment within the first week after surgery. If this occurs, another surgical procedure may be required to reposition the lens.

 

Light Adjustable Lens (LAL):  Post-Surgery Customization Capability

The Light Adjustable Lens (LAL) is currently the only IOL that enables patients to further customize 
their vision AFTER cataract surgery. The LAL offers the ability to make adjustments until vision meets personal desires and lifestyle requirements. 

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How It Works
The LAL is made of a special photosensitive material that changes the shape and power of the implanted lens in response to ultraviolet (UV) light treatments, which are performed by your surgeon in the office AFTER your eye has healed from the standard cataract removal and lens implantation procedure.

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Who It’s For
The LAL is an excellent option for:

• Patients who are looking to optimize their vision and outcomes

• Patients with 0.75 or more diopters of astigmatism

• Patients who are able to follow instructions as listed below . . .

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Patient Responsibilities
In order to customize your vision to your desire, you must:

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• Wear ultraviolet (UV) protective glasses for a period of time.
  These glasses prevent exposure to indoor and outdoor sources of UV light that could cause uncontrolled changes to the LAL. You will be given two pair (clear and tinted) of UV-protection glasses for various situations. You must wear these glasses as directed by your physician.

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• Complete a series of light treatments to fine-tune your lens prescription.
  Once your eye has healed from the initial cataract surgery, you will return to our office to:

1. Have your vision tested. 

2. Select a prescription for your LAL that best meets your preferences and lifestyle requirements. 

3. Complete a required minimum of 2 light treatments.

   • The treatments are painless, non-invasive, and performed by your surgeon right within the office using a Light Delivery Device (LDD).

   • Each treatment will last approximately 90 seconds and be separated by about a week.

   • During this time, you will be able to “test drive” your vision and experience how it will function.

4. Typically, it takes 1-3 light treatments to fully customize your vision. The total number will be based on achievement of the desired vision outcome that you and your doctor selected.

5. Once you have achieved your optimal vision, we will complete a final treatment to permanently lock it in and prevent any further changes. After this, you will be free to enjoy your fully customized vision. 

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NOTE: 
The above points are generalizations. Individual results may vary. Your surgeon can help you decide which IOL is best for you.
 

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Basic or Advanced? Both = Positive Results

   

Nearly 4 million Americans undergo cataract surgery each year to successfully restore their vision. The vast majority of patients experience enhanced quality of life. So, no matter which type of implant you end up choosing, you will most likely improve your vision to a level you haven’t seen in years. 

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When Was Your Last Eye Exam?

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Remember, the best way to protect your vision is to schedule regular, thorough, dilated eye exams to check for hidden signs of sight-threatening conditions. Ask yourself and your family members—"When was your last eye exam?" If it was more than two years ago, it's time to pick up the phone.

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For more information or a comprehensive examination . . .

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Since 1985, Eye Care Specialists has provided comprehensive medical, surgical and laser care for virtually every eye condition to more than 200,000 people. If you would like one of our free educational booklets on any of the eye concerns reviewed on this website, please complete this form or call our Communications & Education Department at 414-321-7520 ext. 207. To schedule a comprehensive eye examination or a second opinion evaluation, call any of our three convenient Milwaukee-area locations directly.

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