A cataract (a cloudy lens in the eye just behind the pupil/iris) interferes with vision by blocking and scattering light that enters the eye; glasses (or contacts) are of limited help because the light is scattered and blocked after it passes through the glasses on its way into the eye. With standard cataract surgery, the cataract is removed and replaced with a clear standard monofocal (single focal distance) lens implant so that glasses (or contacts) work again to help focus for many or all tasks (both near and distant vision) after surgery. Glasses are typically used in these cases to correct myopia (near-sightedness), hyperopia (far-sightedness), and astigmatism to provide focus at a given range (usually distance vision), as well as presbyopia correction to allow for close vision for reading and computers.
Sometimes, a patient may be more dependent on glasses after surgery. An example would be a near-sighted patient who may be able to read without glasses but does need glasses for distance vision in order to drive. Most patients like this choose to see better at distance without glasses after surgery, but with a monofocal standard lens, this means that the near focus without glasses will be blurred, and both distance and near vision may still need astigmatism correction for the best vision.
At the time of cataract surgery, patients may choose optional treatments to reduce or eliminate glasses dependence:
This treatment reduces or eliminates glasses dependence at a given range of vision (most patients choose distance vision). Glasses are then typically used for reading and intermediate vision, but with astigmatism treated, often only over-the-counter reading or computer glasses work well. Occasionally patients may choose better near vision without glasses instead of distance, for either one (monovision) or both eyes. This treatment includes advanced diagnostic screening tests and customized treatment planning, extended related post-operative care, and astigmatism treatment with Limbal Relaxing Incisions (LRI’s) and/or an Astigmatism-Reducing Lens Implant (Toric IOL) as determined by Dr. Seibel.
Toric Lens Implants are a type of Lens Implant that can correct astigmatism. Astigmatism is an optical irregularity that is caused by the cornea being shaped more like a football, than spherical like a baseball. Astigmatism may occur in varying degrees in each eye and can accompany myopia or hyperopia. For individuals with uncorrected astigmatism, images may look blurry or shadowed. Astigmatism can accompany any form of refractive error and is very common.
For cataract patients who have astigmatism, and who do not wish to wear eyeglasses to see clearly at a distance, choosing a Toric Lens Implant can help them be free of glasses for tasks such as driving, that require clear distance vision. Toric IOL technology uses biocompatible materials that have been successfully used in contact lenses and proven safe for the eye.
Toric Lens Implants do not correct Presbyopia, and therefore even with Toric Lens Implants to correct astigmatism after cataract surgery, most patients still require reading glasses or bifocals to be able to comfortably perform near vision tasks such as reading and intermediate vision tasks such as computer work.
This treatment potentially reduces or eliminates the need for glasses for both distance and near vision. This treatment includes advanced diagnostic screening tests and customized treatment planning, extended related post-operative care, and Presbyopia-Correcting Lens Implant, with astigmatism treatment as indicated. The Tecnis Multifocal and ReSTOR implants give the greatest independence from both distance and reading glasses but with a higher possibility of night glare compared to monofocal implants (standard or Toric); fortunately, the majority of these patients (95%) rate the glare as either mild or moderate, and many notice improvement as time passes following surgery. The Crystalens typically gives good distance and intermediate vision without glasses (about 3 to 8 feet away, good for sports and stepping on stairs/curbs and typically better than a standard monofocal lens implant), and less glare risk than a multifocal implant, but patients generally need reading glasses. The Symfony is a new class of lens called an Extended Depth Of Focus type, and is in between multifocals and Crystalens in terms of glare and dependence on reading glasses.
The Tecnis® Multi-Focal IOL is a premium intraocular lens that is specifically designed to offer both distance and near vision. This lens is typically implanted at the time of cataract removal. It is also sometimes used during an elective “refractive lens exchange” procedure when better distance and/or near vision is desired. The goal in choosing the Tecnis® Multi-Focal IOL is to achieve less dependence on glasses or contact lenses.
The Tecnis® Multi-Focal IOL brings objects at varying distances into focus using a technology called diffraction. A series of rings on the entire inner surface of the Tecnis® Multi-Focal IOL focuses the light from objects in our vision at varying distances. This allows for a smooth transition of focus between distant, intermediate and near targets. This lens is a good option for patients who do not like the concept of monovision (one eye focused for distance and the other for near) and who want to reduce the likelihood of needing distance, reading or computer glasses after surgery. Multifocal lenses are more likely than monofocal or toric lenses to produce glare around headlights/streetlights at night; however, most patients (95%) rate the glare as either mild or medium.
The newly approved Symfony® IOL is a device designed to improve vision after cataract surgery beyond just removing the cataract. The Symfony® IOL provides patients with an expanded range of clear vision with little to no need for glasses for distance and intermediate vision, although reading glasses might still be required.
The Symfony® IOL also comes in a toric variety. The toric lenses aid in correcting astigmatism, as well as cataracts and presbyopia.For those who lead active lifestyles and want to reduce glasses dependence, the Symfony® IOL may be the best option for you.
Like a Multifocal lens, the Symfony is more likely than a monofocal or toric lens to produce glare around headlights/streetlights at night; however, most patients (95%) rate the glare as either mild or medium.
The Crystalens® combines the distance vision of a traditional lens implant with a flexible hinge that can provide our patients seamless, natural distance (driving and TV), intermediate vision (seeing steps/stairs, golf and tennis balls at racket/club lengths, talking with friends), and with decent near vision in good lighting. The lens builds on over 30 years of experience with cataract lens implant technology to improve and rejuvenate vision so that patients can accomplish many of their visual needs with reduced dependence on glasses.
An advanced technology laser utilizes Optical Coherence Tomography that provides enhanced imaging for Presbyopia and Astigmatism correcting lens implants as well as enhanced precision Limbal Relaxing Incisions (LRI’s).
At Seibel Vision Surgery, your eyes and vision are of paramount importance. To help you make the most informed decisions regarding the welfare of your vision, we are delighted to be of service and are happy to answer any questions you may have.
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