How to Say Goodbye to Cataracts (and Glasses)

New premium lens implants can correct nearsightedness and farsightedness
Portrait of woman

Cataract surgery has come a long way in the past few decades. What once required a week or more in the hospital is now an outpatient procedure.

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The quality of vision patients can achieve after cataract surgery has dramatically improved as well. Until recently, patients who had cataracts (a clouding of the natural lens in their eye) received a new lens that corrected only one type of vision, usually distance. They still needed glasses for many tasks, such as reading.

Today, cataract patients can choose to upgrade to lenses that offer multiple points of focus or correct for astigmatism, often freeing them from the need for glasses entirely.

Popularity rising

The use of “premium” lenses has increased dramatically since Medicare changed its policies several years ago to let patients choose these lenses if they are willing to pay an additional fee, which typically ranges from about $1,000 to $2,500 an eye, depending on which lens is used.

“If the lens will allow patients to forgo the use of reading glasses, we are allowed to use them now,” says Ronald R. Krueger, MD, an ophthalmologist who specializes in cataract surgery and laser vision correction. 

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Dr. Krueger, who has been named one of 250 innovators in the field of premium lens surgery by Premier Surgeon magazine, explains that although premium lenses can be used to correct vision in patients who do not have cataracts, cataract surgery is still their primary use.

“We can help patients select the type of lens that will allow them to get the additional benefits that they want from cataract surgery,” he says.

Your choices

The premium lenses available today include:

  • Toric lenses. These can be very effective in treating corneal astigmatism, Dr. Krueger says. Prior to their development, the only choices for patients with astigmatism were wearing glasses or undergoing a second procedure in which “relaxing incisions” were made in the eye. “These lenses deliver the most success of any premium lens today,” he says. “They are really a slam-dunk.”
  • Multifocal lenses. As light enters the eye, these specially curved lenses “split” it to correct both near and distance vision, allowing patients to do most regular activities without glasses. Some patients require a period of adjustment right after receiving multifocal lenses as the brain learns to adapt to the new multiple focus.
  • Accommodating lenses. These lenses attempt to move with the eye, focusing much like the natural lens does, to provide clear vision at multiple distances. 

Dr. Krueger says that about 5 percent of cataract patients nationwide choose premium lenses for both near and distance correction, but specialized centers use them in closer to 30 to 40 percent of their patients.

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Such specialists also can provide a “mixed” approach, such as correcting one eye with one type of lens and the other eye with another type of lens to provide maximum visual quality. There can be a period of adjustment with this approach, as well.

More advanced lenses are in development, he notes, including a new accommodating lens with two parts that move relative to each other, and a lens that lets the specialist fine-tune the patient’s focus after implantation by shining a special light pattern into the eye.

Get your doctor’s ‘view’

As with any type of eye surgery, insertion of premium lenses carries a small risk of problems including infection, glare, corneal swelling, blurred vision and incorrect lens placement. Most problems are very treatable.

“If you are considering cataract surgery, be sure to thoroughly discuss all your options with your doctor before proceeding,” Dr. Krueger concludes.

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