No Glasses, No Contacts after Cataract Surgery or Lens Replacement

 

Imagine being able to see without relying on eyeglasses or contact lenses. Now, there are amazing high technology intraocular lenses that make it possible for Dr. Aaker to perform cataract surgery by removing the cloudy lens, and replacing the old lens with a lens that corrects astigmatism or allows you to see both distance and near in a single procedure. This may allow you to break free from eyeglasses or contact lenses.

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Light Adjustable Intraocular Lens​

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Presbyopia Correction

 

​​Astigmatism Correction

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Light Adjustable Intraocular Lens

Anytime we place an intraocular lens, there is always a chance that the intraocular lens power is not what we intended.  With regular cataract surgery we are usually fairly close to the intended correction, but there is a significant percentage of patients can miss the mark.  The light adjustable lens has two aspects that make it an incredible option for vision correction.  The first aspect is that we can place the lens, and fine tune the prescription after doing the original surgery.  This can be then "locked in" to give the most accurate prescription possible with a lens implantation.  The second thing is blended vision.  We can use the light adjustable lens to correct so that you can see both near and far, and you can test it out before we lock it in.  The main downside of the light adjustable lens is that it involves extra follow up visits, and dilation, but it allows for the most accurate correction of your vision.  The light adjustable lens is particularly good for people that want to minimize glare and halos for nighttime driving.

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Presbyopic Correction

As we perform daily activities such as reading, watching television or working at the computer, our eyes are constantly focusing on objects at varying distances – up close, far away and in-between. The ability to quickly change focus throughout our range of vision is called accommodation. Accommodation: The ability of the eye's natural lens to change shape to focus on objects at various distances. Unfortunately, we begin to lose this ability as we grow older, gradually becoming more and more dependent on bifocals or reading glasses. Presbyopia is a gradual loss of flexibility in your eye's lens and surrounding muscle fibers that makes it harder for the eye to focus up close. It's why many people develop the need for reading glasses.  There are two main options for correcting presbyopia: 1) The Light Adjustable Intraocular Lens to provided for blended vision 2) Multifocal intraocular lenses

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Light Adjustable Intraocular Lens

The Light Adjustable Intraocular Lens allows you to blend the vision of both eyes together so that near and distance can be corrected.  It allows you to try it out before locking in the new prescription.  It works best for most functional activities during the day such as looking at your phone, driving and seeing the dash board, or looking at the computer.  It provides for very clear vision with limited side effects.  However, reading glasses may be needed for smaller activities such as reading fine print, etc.  Typically, there are minimal issues with glare or starbursts with nighttime driving.  If you want stronger reading vision, the following section about multifocal lenses may be the better fit for you.

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Presbyopic Multifocal Lenses (such as Tecnis Odyssey, Panoptix Pro, or the Bausch and Lomb Envy): A better option for quality vision at distance, near and anywhere in between.

Until recently, life without reading glasses or bifocals was not an option for cataract patients because traditional monofocal intraocular lenses could only improve distance vision. The multifocal lens, on the other hand, allows you to see near, far, and in between. Most patients find they can read a book, work on the computer, and drive a car-day or night-with an increased freedom from glasses.

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Since there are multifocal lenses of different powers, Dr. Aaker will speak with you to choose the lens that works best for your vision.  Again, every technology has tradeoffs and Dr. Aaker will speak to you to determine if you are a good candidate for these lenses.

 

Range of vision day and night

A multifocal lens will help you have reading, intermediate, and distance vision. Different activities are usually performed with the various depths of vision. Near vision is used to read books, and medication bottles; intermediate vision is used for computer screens, cell phones and car dashboards; while distance vision is usually 7 feet or further from your eyes like street signs and movie screens. The multifocal lenses allow for vision in this full range while a standard lens is usually more limited to single distance range.

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Astigmatism Correction

The surface of a normal eye's cornea has a spherical curve, like the shape of a basketball, light rays passing through it bend toward its center and focus on one spot. Sometimes, the surface of the cornea is curved more like a football, with both flatter and steeper curves. When the surface of the cornea has an uneven curvature, vision becomes distorted. This common irregularity, called "corneal astigmatism," causes blurred or distorted vision because light rays are not focused at one spot to provide clear vision. A person who has both a cataract and corneal astigmatism will not regain high-quality distance vision without glasses after surgery to remove the cataract unless the astigmatism is also corrected.  There are several surgical options that Dr. Aaker may choose to treat astigmatism such as the Light Adjustable Lens, Toric lens implantation, or limbal relaxing incisions (LRI) which are all done at the time of your cataract surgery.

 

Light Adjustable Lens

If you are planning to have surgery to remove a cataract, you now have an additional option... an implantable lens that makes it possible to treat the cataract and correct the corneal astigmatism at the same time. The light adjustable lens as discussed above is able to do custom correction of you astigmatism to a very low level.  It can be adjusted after surgery is performed and then locked in.  It does involve more office visits, and several more dilations than the toric IOL so some people will elect to go with a toric intraocular lens for their correction.

 

What exactly is a Toric IOL?

Surgery to treat cataracts is an outpatient procedure where an eye surgeon removes the clouded natural lens and replaces it with an artificial lens. Traditionally, the surgeon implants a monofocal artificial lens, commonly called an "intraocular lens" (IOL). If you have astigmatism, however, you may still experience blurred and distorted vision because a standard IOL cannot correct corneal astigmatism. To achieve quality distance vision with a standard IOL, you may still require eyeglasses, contact lenses, or further surgery. If freedom from eyeglasses for distance vision is important to you, you now have a better option. The unique design of the Toric lens provides significantly improved distance vision and may reduce the need for corrective lenses.

 

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