Choices in Cataract Surgery
Since Sir Harold Ridley implanted the first intraocular lens on November 29, 1949, at St Thomas Hospital in London, there have been incredible advances both in intraocular lenses and how cataract surgery is performed. Today, regardless where you go in this country, the removal of the cataract is performed in much the same way and the choice of the exact method of cataract removal is best left to the surgeon you choose. He or she will choose the best method for you and the method with which they are most skilled. Your choice comes into play when it comes to what kind of lens to have implanted in your eye.
A monofocal lens is a lens that has a single focal point. This means that the lens is only able to correct a patient’s vision for only one distance. Most patients who choose the monofocal lens elect to have their vision corrected for distance vision, which gives them their best vision at a distance with little or no glasses correction, but they still need glasses for reading. They do not correct for astigmatism. Monofocal lenses were the first lens implants created and have advanced significantly in materials and design over the decades. These lenses are covered by Medicare and insurance companies.
A toric lens implant is a lens that not only corrects near or far-sightedness, but also corrects for astigmatism. Astigmatism is an asymmetric curvature of the cornea, the clear front part of the eye. You can think of it as the difference between the curvature of the surface of a basketball compared to the surface of a football. Implanting a toric lens in patients who have significant astigmatism can significantly reduce the chance they will need glasses to correct their distance vision, but they will still require reading glasses to see things up close. Medicare and insurance companies do not cover the cost of these lenses and the patient will have to pay for the increased cost of the lens.
A multifocal lens is an implant that can correct a patient’s vision both at a distance and up close. It has two focal points and therefore projects two images onto the retina, the light-sensing layer on the back of the eye. The brain then learns to pay attention to the image that is in focus. The multifocal lens used in our practice is the ReSTOR lens made by Alcon Laboratories, and more information can be found at www.acrysofrestor.com. This lens does not correct for astigmatism and the increased cost of the lens is not covered by Medicare or insurance.