Intraocular Lenses (Cataract Lens) Overview San Jose
Video: Cataracts & Lens Implant Choices
Cataract Lens Implant Choices
A cataract occurs when the natural lens inside your eye becomes cloudy. When we remove the cataract from inside your eye, it will be replaced with a clear plastic lens called an “intraocular lens” implant (IOL). This lens implant will aid in the focusing of light onto the back of the eye. Although our goal is to try to have “glasses-free” vision as much of the time as possible after surgery, for a number of optical reasons we do not always achieve this goal. Accordingly, following surgery all patients undergoing cataract surgery must plan for the possibility of wearing glasses some of the time for certain tasks regardless of the implant chosen. This also applies to patients having toric and multifocal implants. Alternatively, if you desire close to glasses-free vision after cataract surgery, in some patients, (if deemed to be safe) LASIK can be performed to help achieve better vision without glasses after your cataract surgery.
Due to advances in medical technology, we now have a number of choices for the type of lens implant which will be placed in the eye. Below is a summary of the choices. The physicians and staff at Optima are here to help you make the choice, but ultimately, the choice is up to the patient and the family.
- BOTH EYES ADJUSTED FOR DISTANCE VISION. The power of the intraocular lens for both eyes is adjusted for distance vision. Patients will need glasses for reading and for intermediate tasks such as the computer, dashboard, cell phone, and wristwatch, and other near and intermediate tasks. Because of how each eye heals, even those patients whose eyes are adjusted for distance vision may still need distance glasses for functions such as driving, T.V., movies, and golf.
- ONE EYE ADJUSTED FOR DISTANCE AND THE OTHER EYE ADJUSTED FOR NEAR (MONOVISION, BLENDED VISION). By using different implant powers for each eye, we can adjust the vision in one eye for the distance and in the other eye for near tasks such as reading or computer. Some people currently achieve this with contact lenses. Even with this option, patients may still need glasses for distance vision, (especially night driving), and possibly for near. Most, but not all, patients can get used to having one eye adjusted for the distance and the other eye adjusted for near. If you have high astigmatism, we can also use the toric lens to achieve monovision.
- FOR PATIENTS WITH HIGH AMOUNTS OF ASTIGMATISM. Astigmatism is when the eye is shaped more like a football than a basketball. There is a lens implant option called the “toric” IOL. This lens has the astigmatism incorporated into the implant (like your glasses). The advantage to this lens upgrade is that, because it significantly reduces the astigmatism, people are often much less dependent upon glasses following surgery for the distance. However, unless we do monovision with the toric lens, glasses will be required for computer and reading.
- MULTIFOCAL IMPLANTS. Since 2003, we have been using multifocal implant lenses. This is the latest in implant technology. With this option, each eye receives a multifocal lens. The goal is that when looking at a distant object, patients can see well in the distance with both eyes. Also, patients can see well with both eyes when viewing intermediate targets such as the dashboard, a cell phone, a computer, or a wristwatch. Often, near targets such as menus and the newspaper can also be seen more clearly than with the standard lens implant. However, for small print, reading glasses will be necessary. Although most patients with these implants are glasses-free most of the time, it is important to realize that these lenses are not Occasionally distance and/or near glasses are required. This is the best option for patients who wish to have as “natural” vision as possible. Although we strive for glasses-free vision, these lenses and the healing of the human eye are never perfect and occasionally the use of glasses or corrective laser surgery may be necessary. More light maybe required while reading and some patients may see glare, halos, or starbursts while driving at night.
- COST OF THE PROCEDURE. Medicare and insurance companies pay for the removal of the cataract and the standard distance implants. However, they do not pay for the lens upgrades or the refractive component and testing required for the multifocal or toric implants. The cost of the lens and the refractive component for the multifocal implant is $2,850 per eye above and beyond what is paid by Medicare and/or other insurance companies. The out-of-pocket cost for the “toric” (astigmatism) implant and the refractive component is $1,850 per eye. The cost for the extra testing pre-operative, intra-operative (ORA) and post-operative measurements required for blended or monovision vision is $750 per eye. ORA is a measurement to improve the accuracy of the lens implant power taken during the operation after the cataract has been removed. The cost also includes the cost of a LASIK touch-up if Dr. Mandel deems that this would be safe and effective.
- Patients who have had prior LASIK, PRK, or RK will require additional pre-operative testing, measurements, and computer programs to determine the power of any lens implanted at the time of cataract surgery and also the use of the intra-operative ORA test to help refine our implant measurements which helps us to better achieve our visual target more accurately. Accordingly, there is an additional charge of $750 per eye for these additional measurements. This charge is included in the cost of a multifocal or toric implant. The cost of a LASIK or PRK touch-up if deemed to be safe and effective by Dr. Mandel is also included in this price.
- LASER-ASSISTED CATARACT SURGERY. For patients with astigmatism or those wishing to use a multifocal lens, or toric implant we are proud to be one of the few centers to offer laser-assisted cataract surgery. This allows us to perform part of the surgery using the latest laser technology. We employ the LenSx laser to make the corneal incisions and to open the front part of the cataract to more precisely position the implant. Laser-assisted cataract surgery is the latest in state-of-the-art cataract surgery. There is a charge of $1750 per eye for Laser-assisted cataract surgery which also includes the use of the ORA intra-operative wavefront measuring device to help customize the lens implant measurements. The cost of a LASIK or PRK touch-up if deemed to be safe and effective by Dr. Mandel is also included in this price.
We hope that this brief summary will help you to make a decision as to which implant you desire. As always, never hesitate to ask any of the physicians or staff any question at any time. We are committed to ensuring that you have the best possible outcome from your cataract surgery.
FOR YOUR CONVENIENCE…
For premium lenses, we accept Visa, MasterCard, American Express, Discover, debit cards, or cashiers check. We are also pleased to offer Care Credit for independent financing of these lenses. Please feel free to ask us about this option.