Premium Implants

Why do I need this man-made lens implanted?

The natural human lens, which started out crystal clear in your youth, has now become cloudy.  This lens has a certain power to it, the same way that a camera lens has a certain power.  When the cataract (the cloudy lens) is removed, it’s like taking the lens out of the camera: you won’t get a good picture until you replace the lens.  The lenses are typically made of acrylic (plastic), silicone, or a similar compound and they have been implanted in eyes for more than 50 years.  They are designed to last for your lifetime and about 5 million lens implants are done worldwide per year.  This lens is implanted in the same position as the human cataractous lens, which was removed.  It is behind the iris (the blue, green, or brown part of the eye) and it is not visible to other people looking at your eyes.  You won’t feel this lens or even realize that it is implanted in the eye. This lens is NOT like a contact lens. This lens is permanent and is implanted inside your eye.  You will not feel it and it will not come out of the eye.

What are the three basic types of lens implants?

There are three types of implant: Standard single focus, toric and premium accommodating.

Standard Single Focus Implants

The standard lens implant is a single-focus lens with the focal point typically set for distance, with glasses being required for intermediate or near vision. The eye adapts quickly to this lens implant as this type of lens provides the best image quality and most natural vision possible, although just at the single focal point (distance).  With the astigmatism treated or managed and a single-focus lens implanted, the distance vision will be excellent without glasses, but glasses will be required for computer use or reading. 

Toric Implants

If you have astigmatism and this is less than one and a half dioptres in power, this can usually be fixed by extra incisions performed at the time of cataract surgery.  However, if your astigmatism is more than one and a half dioptres in strength, then these incisions are not usually sufficient.  We are now finding that implants with astigmatism added to them, so-called Toric implants, are much more effective at reducing astigmatism and therefore your need for glasses following surgery.  The current Toric implants that I am using are fixed distance lenses with an astigmatic component added to them.  You will need to use reading glasses following surgery with a Toric implant. 

Premium Accommodating Implants

In our practice we use the Crystalens, which is an accommodating intraocular lens that, unlike a standard IOL, can treat both a person's cataracts and presbyopia—loss of near and intermediate vision. You probably noticed in your forties that you started to lose some of your up-close vision and had to start wearing reading glasses.

Crystalens not only treats your cataracts (a clouding or hardening of your lens), but can also reduce or eliminate your dependence on glasses. It does so by recreating accommodation (the process by which the eye changes from near to distance vision) similar to your eye's natural lens. The Crystalens can reduce or eliminate glasses for most activities, including: reading a book, working on the computer, and driving a car.  

In our hands approximately 80% of patients who have these implants placed in both eyes will be able to function perfectly adequately for near, distance and intermediate tasks without glasses.  Some patients do occasionally need glasses for fine work following surgery, but the majority of patients are extremely delighted with the results of this implant.

Which lens will you put in my eye?

The lens that we will implant in your eye depends on your visual needs and preferences and whether you elect to have a premium multi-focal lens.  All lenses are fully CE approved, are of the highest quality and are from top-name ophthalmic manufacturers.  We only use high-end implants with the best optics – the same ones that we would implant in our own family and friends. 

The single-focus lenses that we prefer are referred to as aspheric lenses since they address the sharp focusing of the eye as well as the spherical aberration in order to provide a better quality image, similar to a high-end Nikon camera lens.   Studies have even shown better driving performance in people who receive these aspheric lenses.  If your concern is the best quality of vision and you don’t mind wearing glasses for any intermediate or near work, then this is the best lens for you.

The premium accommodating lenses allow a much greater freedom from glasses, with 90% of patients in the official FDA studies never or only occasionally using glasses for distance, intermediate and near vision. 

Because the lens uses to original cillary focusing muscle, it takes a few weeks for the brain’s visual pathways to adapt.  As the brain adapts, these visual artifacts significantly lessen and the majority of patients are quite happy and state that the benefits of their Premium accomodating lenses far outweigh any other issues.  If your concern is good vision and you would like to reduce or eliminate your need for glasses for distance, intermediate and near, then a Premium Accommodating Implant is the best choice for you.

How do you calculate what power lens to use?

Since each eye is different, before the surgery, your eyes will be measured with specialized equipment using light-waves or ultra-sound in just a few minutes.  Remember that cataract surgery is to correct cataracts and that treating astigmatism or using Premium Accommodating Implants are separate procedures and costs. 

Will I need glasses after the cataract surgery?

Cataract/Refractive Lens Surgery with a Single-Focus Lens:

Yes, glasses required for distance, intermediate, and near.   If you choose cataract surgery alone, with a single-focus lens, then you may have issues with astigmatism after the surgery.   You may need glasses to address this astigmatism and you will certainly need glasses to see intermediate distances, such as computer work, as well as to see near points, such as reading fine print.  Remember that the primary goal of cataract surgery is to correct cataracts and not to reduce the need for glasses.

Cataract/Refractive Lens Surgery with a Single-Focus Lens + Astigmatism Management: 

No glasses for distance, but yes, you’ll need glasses for intermediate and near work.

If you choose cataract surgery with a single-focus lens and astigmatism management/treatment, then you will achieve sharp vision for distance and will likely pass your driving test without glasses.  You will have the best quality vision possible with the lowest incidence of visual disturbances.  If you are a perfectionist, if you demand the best image quality and if you are willing to use glasses for intermediate and near work, then this is the best option for you.

Cataract/Refractive Lens Surgery with a premium accommodating implant + Astigmatism Management:

Eliminate or significantly reduce the need for glasses for distance, intermediate, and near work.  If you choose cataract surgery with a premium lens and astigmatism management / treatment, then you will regain a more full spectrum of vision, at a variety of focal points.  In the official FDA study, 80% of patients with these lenses never used glasses or only occasionally used them.  Remember that this type of vision requires a few weeks for the visual system to adapt.  If you really hate using glasses, if you are motivated and if you have an easy-going personality, then this may be the best option for you.