IOLs: New Lease on Sight

“I can’t improve your vision further with corrective lenses,” was the verdict from my ophthalmologist a few months ago. “Your cataracts prevent it. We have been talking about doing something about that for three years at your regular eye exam,” she said, going further with the bad news.

Cataracts are a common age-related condition in which the natural lens of the eye becomes cloudy, causing vision to deteriorate. The National Eye Institute estimates that about 50 percent of Americans have cataracts by the age of 75. While cataracts are not painful, they can severely interfere with quality of life and can cause blindness if left untreated.

Cataract symptoms include blurred vision; faded color vision or colors appearing more yellow; difficulty driving at night and sensitivity to glare. Cataracts are a normal part of aging that happens when proteins in the eye start to break down. Some people may be predisposed to cataracts due to genetics or certain health conditions. When vision loss starts to interfere with tasks such as driving, reading or recognizing faces, surgery may be considered. According to the American Refractive Surgery Council, cataract surgery is widely known as a safe and effective procedure, with a complication rate under 2 percent.

Ophthalmic surgeons are highly trained ophthalmologists, typically board certified and fellowship trained, with specialties such LASIK vision correction, cataract surgery, refractive lens exchange, IOL surgery and corneal transplantation. In my consultation with the recommended surgeon, he assured me, “Up to 90 percent of cataract surgery patients are very satisfied with their decision to have the surgery. Most patients report increased happiness, sense of independence and overall appreciation for life,” he affirmed. Post surgery, my addendum is, freedom from constantly asking myself, “Where on earth did I put my glasses?”

Intraocular Lens Choices
At the consultation, after intensive testing and ocular measurement, I was presented with the choice of lenses: monofocal, multifocal, extended depth of focus, accommodative and toric lenses. Standard monofocal IOLs correct vision at a single distance. Some premium IOLs are designed to correct refractive errors such as nearsightedness, farsightedness, astigmatism and presbyopia, reducing the need for glasses. Toric lenses are designed to correct astigmatism, and accommodative lenses can adjust focus for different distances. Depending on the IOL you choose, you might still need reading glasses or glasses for other specific tasks.

Costs range from the lowest, monofocal lenses, which many insurance companies cover, to the highest, multifocal and toric. Faced with the possibility of still needing glasses for near vision, I chose multifocal toric lenses in both eyes.

Following surgery on each eye, two weeks apart, there were restrictions. A family member drove me home from surgery wearing a great pair of wraparound dark glasses. Eye drops were needed for six weeks for each eye. I experienced enhanced clarity and brighter colors immediately. Swimming and strenuous exercise were restricted for several weeks after surgery; no problem with any of these! Day-after-surgery and weekly follow-ups were required, which I was able to drive myself to.

According to a study published in Ophthalmology, cataract surgery satisfaction, as well as frequency of visual symptoms, may be partially dependent on the type of intraocular lens a patient receives. Patients who receive premium IOLs report more visual symptoms and less satisfaction than those implanted with monofocal lenses, the report shows. “Patients receiving premium IOLs probably have higher criteria for meeting satisfaction, because they have requirements not only for distance vision, but also for intermediate vision and near vision, and for eyeglass independence, in addition to an out-of-pocket expense for the device,” according to researchers. “There are still factors associated with dissatisfaction and symptoms that cannot be explained by visual acuity alone. The role of neural adaption could vary by patient and by type of IOL, accounting for unexplained optical phenomenon causing dissatisfaction, and the four- to six-month postoperative period for reassessment might not be long enough for neural adaption.” In all honesty, I completely agree with the higher criteria for satisfaction, which thankfully my surgery achieved. At the three-month point, my vision is 20/20, and my only future investment will be in a stylish pair of UVA/UVB protective sunglasses!

Protecting Your Eyes
Lifestyle choices can make a difference in taking care of your eyes and delaying cataract formation. Shield your eyes from harmful ultraviolet UV rays by wearing sunglasses that block 100 percent of UVA and UVB rays. Eat foods rich in antioxidants, vitamins and phytonutrients, such as leafy greens, colorful fruits, fatty fish and vegetables. Avoid smoking and limit alcohol consumption, as these can increase oxidative stress in the eyes, contributing to cataract formation.

So here’s to a new lease on sight, and a new-found freedom from an annually changing set of expensive eyewear. As my sister said, “Pay now, or pay for the next ten years!”

Sources: nei.nih.gov, ophthalmologyadvisor.com and mycorneacare.com.