Where to find it
Q. I have decided to have cataract surgery and have been told there is a choice of lens implants. I would like to know more about these lenses.
A. A cataract is a clouding of the eye's lens that may grow and cause vision problems. Common symptoms are: blurry vision, faded colors, glare, halos around lights and poor night vision.
While cataract development can be related to diabetes or smoking, aging is the reason for most lens clouding. More than half of Americans by age 80 have a cataract or have had cataract surgery. Protecting eyes from ultraviolet light may delay cataract development, and a diet high in antioxidants may decrease the risk of age-related cataracts.
The treatment for cataracts is removal of the clouded natural lens and replacement with an artificial intraocular lens. Like contact and prescription eyeglass lenses, IOLs have varying focus specifications. Traditionally, monofocal IOLs have been used and they are still the most common type. Each one is set for a single focal distance. The patient then uses prescription glasses for seeing at other distances. The cost of cataract surgery using monofocal IOLs is generally covered by Medicare and private insurance.
The other replacement lenses are called "premium" IOLs. They address vision situations such as astigmatism and the desire for continuous focus, potentially eliminating the need for prescription glasses. Multifocal IOLs have multiple zones, allowing for an extensive range of clear vision. Accommodative IOLs move to provide midrange and distance vision. Toric IOLs correct astigmatism. If a premium IOL is implanted, Medicare covers no more than the cost of standard IOL surgery.
Cataract surgery is done in an outpatient setting with local anesthetic and is generally a safe procedure. It typically takes between 15 minutes and an hour. Posterior capsule opacification, a thickening of the back of the lens capsule, also known as an after-cataract, is a common complication. It can usually be treated with a simple laser procedure. Eye infection and bleeding are risks of the surgery. Other possible, though rare, complications include dislocation of the IOL, problems with glare, glaucoma, drooping eyelid, retinal detachment and loss of vision.
Not all cataracts need to be removed. The decision to have surgery often depends on how much the resulting vision problems affect quality of life. For example, failure to pass a driver's examination is frequently a reason to have the surgery. Each individual situation is unique and requires detailed consultation with an ophthalmologist.
Marnie Ceazan volunteers with the Grillo Center, which offers free, confidential research to assist in health understanding and decisions. To use this service, contact us at grillocenterhealth.org, 720-854-7293 or 4715 Arapahoe Ave., Boulder. No research or assistance should be interpreted as medical advice. We encourage informed consultation with your health care provider.