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Cataract Lens Implants for Astigmatism & Near Vision-ReSTOR®, Tecnis® & Crystalens®-Multifocal & Toric at Alabama Eye & Cataract Center in Birmingham, AL

By Marc Michelson, M.D.

About Lens Implants
Today, at Alabama Eye & Cataract Center, P.C., there are many types of Intraocular Lens Implants (IOL) that Dr. Michelson can use in order to provide you with the best results to match your lifestyle and activities after cataract surgery. These different types of lens implants include Monofocal Lens Implants which are the most basic type of lens implant and only correct distance vision and not arms length or close reading vision, Aspheric Lens Implants which offer a higher quality of distance vision but still do not correct arms’ length or close reading vision, Toric Lens Implants for those patients with astigmatism and Near Vision Presbyopia Correcting Multifocal Lens Implants such as the Tecnis® Multifocal Lens Implant (IOL), the  AcrySof® ReSTOR® Multifocal Lens Implant (IOL) or the Crystalens® Accommodating Lens Implant which correct distance vision, as well as arms’ length vision and close reading vision for most patients.

Monofocal Lens Implants
A Monofocal Lens Implant is the basic typeof lens implantthat was used for many years to correct distance vision after cataract surgery. For approximately the first thirty years of lens implant surgery all lens implants were of a type called a Monofocal Lens Implant. A Monofocal Lens Implant can provide good vision after cataract surgery-but only at one set distance-usually for seeing things at a distance such as for driving or going to the movies-and with no special optical characteristics to help you see in dim illumination or poor lighting conditions. A Monofocal Lens Implant does not correct intermediate or arms’ length vision for doing things like playing cards and seeing the golf ball on the tee or even seeing computer screens clearly. Nor do Monofocal Lens Implants correct near vision for doing things up close such as seeing medicine bottles, reading or keeping your golf score as these tasks require the correction of Presbyopia. Thus patients electing to have Monofocal Lens Implants will be dependent on glasses either some or most of the time in about 70% of cases.

Aspheric Lens Implants
An Aspheric Lens Implant is a type of lens implant that is specifically designed to reduce the visual disturbances caused by the optical aberrations found in ordinary lens implants. This reduces the tendency to see "glare" that you might experience with basic lens implants and thus can offer improved sharpness and contrast, helping patients in certain difficult lighting conditions. Aspheric Lens Implants only correct distance or far vision, such as that required for driving. Aspheric Lens Implants do not usually correct intermediate or arms’ length vision, such as that required for viewing computer screens, and do not correct near vision as required for reading. Patients who wish to have the best quality of distance vision may wish to consider an Aspheric Lens Implant, but need to remember that it will still be necessary to wear reading glasses or bifocals to correct their intermediate and near vision.  Dr. Michelson has observed that some patients with aspheric monofocal lens implants remarkably have the ability to not only see 20/20 at distance, but also have the functional capability to read well at near without the need for reading glasses. This capability is termed “Pseudoaccommodation.”  By performing topographical mapping of the cornea and evaluating certain wavefront characteristics of the cornea, pseudoaccommodation can be predicted in many patients. Results of Dr. Michelson’s studies in pseudoaccommodation with aspheric intraocular lenses was presented at the annual meeting of the American Society of Cataract and Refractive Surgery in Chicago in 2012 where the presentation was awarded the Best Paper of Session.

Astigmatism Correcting Toric Lens Implants
Astigmatism Correcting Toric Lens Implants (IOL) are a type of lens implant that can correct astigmatism. Astigmatism is an optical aberration that is caused by the Cornea being shaped more like a football, than spherical like a basketball. For cataract patients who have astigmatism and who do not wish to wear eyeglasses to see clearly at a distance, choosing an astigmatism correcting Toric Lens Implant may help them to be independent of glasses for tasks such as driving that require clear distance vision. Toric Lens Implants do not usually correct Presbyopia, and thus 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.

Near Vision Presbyopia Correcting Lens Implants
Near Vision Presbyopia Correcting Lens Implants provide vision correction after Cataract Surgery at the full range of distances-far or distance vision, arms’ length or intermediate vision and up close near vision. Depending on your specific vision requirements Dr. Michelson might suggest implanting the Tecnis® Multifocal Lens Implant (IOL or the AcrySof® ReSTOR® Multifocal Lens Implant (IOL) The specialized optical design of the these lens implant work in a way to help you achieve your vision correction goals of being able to see at a variety of distances after cataract surgery-without being dependent on eyeglasses. Presbyopia correcting lens implants correct both your distance vision and your Presbyopia after cataract surgery. For the vast majority of patients, having a Multifocal Lens Implant means that you will be able to see at distance and up close without being dependent on eyeglasses.

As with any surgical procedure, there are always risks as well as benefits. During your eye examination and cataract consultation, we will perform a thorough cataract evaluation including the necessary testing and then arrange the scheduling of your cataract surgery. In addition, we will spend the time necessary to review the everyday activities that are most important to you-and whether being independent of glasses for those activities is something that you would like to achieve. As you prepare for your visit to Alabama Eye & Cataract Center for your examination it will be helpful if you begin thinking about what those activities are so that you can discuss them and explore them with our staff.

If you decide to have an astigmatism correcting Toric Lens Implant or a Near Vision Presbyopia Correcting Multifocal Lens Implant, our staff will make sure to review your questions and fully explain any additional fees related to the Lens Implant that you might be responsible for. Medicare and most insurance plans cover the surgical facility fee for cataract surgery and the surgical fee for cataract surgery-but not the cost of additional testing and the actual advanced technology lens implants. In most cases, Medicare or the insurance provider asks Alabama Eye & Cataract Center to bill you for the additional cost of the necessary testing, the lens itself and its implantation. Our staff will be pleased to review any costs as well arrange easy affordable monthly payments to fit your budget, should you decide that this lens is your best choice.

If you or someone you know has cataracts or is considering cataract surgery and would like to learn more about cataract lens implants, please call Alabama Eye & Cataract Center at 205-930-0930 to schedule an appointment.