Full Focus Cataract Surgery

As we get older, the natural lens inside the eye undergoes a series of changes that result in different types of vision loss. Two primary causes of vision loss with age are presbyopia and cataracts.

Presbyopia, the loss of reading vision, is a condition that affects almost everyone over the age of 50. Presbyopia occurs when the natural lens of the eye becomes harder and less flexible. This reduces the eye’s ability to switch from seeing objects at a distance (for driving) to seeing objects that are near (for reading).

Cataracts affect most people over the age of 65. This condition occurs as the natural lens inside the eye becomes discolored and clouded. This clouding scatters the light passing through the eye, resulting in hazy or blurred vision. If left untreated, cataracts can eventually lead to blindness.

Once a cataract has formed, the only way to restore clear vision is to remove the clouded lens and replace it with a clear, permanent implant called an intraocular lens (IOL). This is done during a painless, eight-minute, outpatient procedure. The eye is numbed with anesthetic drops, no injection is used. Then, the clouded lens is dissolved with ultrasound and washed out through a tiny incision and the implant is put in place.

Following surgery with traditional artificial lenses, patients often still need to use their reading glasses or bifocals to be able to see objects at close range. This is because traditional IOLs implanted during cataract surgery typically only correct for distance vision.

Presbyopia-correcting lens implants, including multifocal and accommodating IOLs, have moved cataract surgery beyond simply restoring vision loss. These lenses can restore the eye’s ability to focus far away, up close, and at all points in between. Whether it's reading a package label or working on a computer, driving at night or golfing, today most people who undergo cataract surgery have the option to choose a lens that can enable them to be free of glasses while performing the activities that are most important to them.

Similar in concept to bifocal contact lenses, multifocal lens implants are designed with both near and distance viewing zones. Unlike bifocal or “progressive” spectacles, these lens implants do not require the patient to gaze in different directions (i.e., up for distance and down for near) in order to utilize each zone of the lens implant. The most popular multifocal IOLs are the ReStor and ReZoom implants. In one study, 92% of people with a multifocal implant said that they could perform most of their daily activities without glasses. Reading vision is particularly good with this type of lens. Some patients notice haloes or glare around lights at night, so multifocal lenses may not be the best choice for people who do a lot of night driving.

Crystalens, an accommodating IOL, works by moving with the muscles in your eye, much like the way your natural lens works. Crystalens is best for active patients who do not mind wearing glasses for very fine print and require good vision for night driving. Unlike the multifocal IOLs, there are fewer reports of night-time symptoms, but the near vision achieved with this lens is weaker than that of the other two presbyopia-correcting IOLs.

With the availability of these new intraocular lens technologies, the modern age of cataract surgery demands a refractive-surgery mindset. In the old paradigm, surgeons typically had a standard favorite IOL that they implanted in most patients without much discussion about the IOL itself. Today, your surgeon can offer a much wider range of choices, tailoring the best lens implant to your lifestyle needs.