IOLs (Intraocular Lenses) are lenses that are placed in the eye during cataract surgery to replace the natural lens. These lenses can also replace a healthy lens as a vision correction device in a procedure called refractive lens exchange. Premium IOLs offer special advanced features beyond the standard single vision IOL’s that are the most commonly used. The special types of premium IOLs are aspheric, toric, accommodating, and multifocal IOL’s.
 

Understanding Premium IOL Types

Aspheric IOLs

Typical non-aspheric IOLs are uniformly curved making it easier to manufacture, but at the same time they increase the chance of causing distortion in vision. Aspheric lenses have changing curvature which helps to reduce distortion and improve clarity, especially at nighttime.
 

Toric IOLs

These lenses are specifically designed to help correct ASTIGMATISM as well as nearsightedness and farsightedness.
 

Accommodating IOLs

Accommodating IOL’s can tilt slightly forward when you look at objects that are close to the eye. This helps to improve near vision when you are performing actions like reading a book.  While they are not necessarily as sharp as bifocals, patients have a reduced need to use reading glasses while still maintaining excellent distance vision.
 

Multifocal IOLs

If you require a bifocal or trifocal lens in your glasses and you do a lot of near work, this may be a good choice for you. Different portions of the lens allow for better vision at different ranges so patients can see far as well as near without glasses.  However, the design of many of the lenses can cause some glare at night when the pupils dilate naturally.
 

History of Premium IOLs

Premium IOLs have been approved by the Food and Drug Administration (FDA) since the 1980s. Prior to FDA approval, when patients had cataract surgery, their cataracts were removed and were not replaced with anything.  These patients were required to wear very thick eyeglasses or specialized contact lenses to correct their vision. New technologies in the optical world have allowed for a wide variety of available premium IOLs to help accommodate each patient's vision needs.  Deciding which specific type suits you best will depend on several different factors.  If you are interested in premium IOLs for your cataract surgery, ask Dr. Kubota to discuss which one is right for you.
 

Patient Factors

After recovering from cataract surgery, many patients expect that their vision will be completely restored to peak performance up close as well as in the distance. However, surgeons are careful to warn against this unrealistic expectation and explain the realities of the surgery, possible side effects, as well as realistic expectations depending on the type of IOL they choose.  Single vision IOLs provide focus at only one specific distance and glasses will be required to see at other distances, but are often covered under a patient's medical insurance.  Some patients desire to not wear any eyeglasses after surgery and are willing to pay extra for the premium IOLs.  If the patient does not mind wearing corrective lenses after surgery, then standard single vision IOLs may be the best option. 

Patients with certain medical histories may also be poor candidates for premium IOL surgery. Some of these conditions include:

• Advanced macular degeneration

• Anterior basement membrane dystrophy

• Fuch’s dystrophy

• Weak zonules

• Glaucoma

• Post-refractive surgery patients

This list is not comprehensive, so it’s important to consult with your surgeon and bring a detailed medical history for their review.

Finally, patients may also want to consider their careers when weighing the value of this surgery. Patients who are required to read on computer screens for extended periods of time (i.e., print editors, office jobs) may be ideal candidates for premium IOLs.  In contrast, individuals that require mostly long-distance acuity and need to see far away in the dark, like truck drivers, pilots, or even some photographers, may find that some of the issues with these lenses are not suited for their needs. Individuals sometimes complain of “halos” during the night when looking toward a light at longer distances with some premium IOLs.
 

Further Consideration

While premium IOLs do have some limitations, they offer an excellent choice for many individuals. However, it is important to meet with Dr. Kubota and your cataract surgeon to fully discuss all of the available options to find your best fit as well as to make sure that you understand all of the potential risks and restrictions that this operation poses.