Dr. Privett's Patient Education SiteDr. Privett's Patient Education Site
As our eyes age, the lens inside our eyes changes. In our 40s, the lens becomes less flexible leading to the loss of the ability to focus up close. This loss of near focus is known as presbyopia. In our 50s, the lens continues to change often leading to worsening glare and less than perfect vision. In our 60s and 70s, the lens becomes clouding leading to blurry vision. Fortunately, a quick outpatient surgery can be performed to remove the cloudy lens and replace it with a clear plastic lens called an intraocular lens or IOL.
Intraocular lenses can be customized to correct nearsightedness, farsightedness, and astigmatism. Specialty lenses can also extend the depth of focus reducing the need for bifocals or reading glasses. When we perform cataract surgery with the intent to reduce to need for glasses, we call this refractive cataract surgery.
The page provides information regarding how cataract surgery works and what lens options are available. I want all of my patients to be fully informed of their options so that they make decisions that best fit their individual needs.
Brian Privett, MD
Director of Refractive Surgery
Iowa Eye Center
Dr. Privett performs cataract surgery at the Surgery Center Cedar Rapids and the Mercy Hiawatha Surgery Center. Both of these facilities are top notch with the latest technology and equipment available. An anesthesiologist is present for the procedure to provide mild sedation and allow to patient to relax. After numbing the eye with drops and lidocaine, a small incision is made in the clear part of the eye called the cornea. A circular portion of the bag that contains the lens is removed to allow access to the lens. The lens is then broken up into small pieces and vacuumed out of the eye using a process called phacoemulsification. The new lens is then placed into the eye through an inserter. The lens then unfolds inside the eye similar to a ship in a bottle. The incision is so small that it usually self-seals without the need for sutures. The entire process only take 20-30 minutes and the patients goes home the same day.
Astigmatism can cause distortion of vision at distance and near. If someone has minimal to know astigmatism, a standard monofocal intraocular lens will often produce clear distance vision even without glasses. If someone does have significant astigmatism, they may still have distortion without glasses after cataract surgery. This distortion can still be corrected with glasses or contacts.
Patients can elect to have their astigmatism corrected with a toric intraocular lens. These lenses are not covered by insurance, but they are a great option for patients interested in seeing better without glasses. Dr. Privett will let you know if you would benefit from a toric lens at you preoperative visit.
Presbyopia causes us to loose our near focus as the lens inside our eye ages. The standard monofocal lens is usually used during cataract surgery to correct distance vision, but patients will often require reading glasses or bifocals afterward.
There are a couple of ways to correct presbyopia with cataract surgery. One way is called monovision which involves focusing one eye for distance vision and the other eye for near vision. Without thinking about your brain chooses which eye to use when focusing on something.
Another option for the correction of presbyopia is to implant a multifocal lens such as the PanOptix or Symfony intraocular lens discussed below.
Can you remember when you were in your 20’s and 30’s and could see all distances whether far, intermediate, or near? The PanOptix trifocal intraocular lens is the first and only trifocal intraocular lens in the United States. This lens in not covered by insurance, but patients who want to reduce the need for bifocals or reading glasses are very happy with this lens. This lens produces excellent distance vision. It can also allow for intermediate vision without glasses such as when using a computer. Finally, the lens provides for near vision such at looking at a cell phone or reading a book. Astigmatism can also be corrected with this lens.
Aside from the extra cost, the only other downside of this lens is some nighttime glare. This is due to the rings in the lens that divide the light into distance, intermediate, and near. Most patients are not significantly affected by this glare and it often improves over time.
To be a candidate for a PanOptix IOL, the rest of your eye should be normal. Dr. Privett performs a special evaluation of the eye to test for corneal and retinal disease for patients interested in this lens.
Like the PanOptix lens, the Vivity lens can also reduce your need for bifocals. This lens is an extended depth of focus intraocular lens and it works differently that other multifocal lenses. This lens in not covered by insurance, but patients who want to reduce the need for bifocals or reading glasses are very happy with this lens. This lens produces excellent distance vision. It can also allow for intermediate vision without glasses such as when using a computer or cell phone. A patient might need reading glasses for heaving reading or seeing fine print at a close distance. Astigmatism can also be corrected with this lens.
To be a candidate for a Vivity IOL, the rest of your eye should be normal. Dr. Privett performs a special evaluation of the eye to test for corneal and retinal disease for patients interested in this lens.