FAQ
Will the use of presbyopia correcting intraocular lenses (PCIOLs) give me freedom from glasses?
Will PCIOLs give me the same quality of vision I had when I was 20?
How does a presbyopia correcting intraocular lens replace a cataract?
How long after will I have to wait after surgery until I see my best?
Do multifocal presbyopia correcting intraocular lenses require a period of adjustment?
Will I see glare or halos around lights with multifocal presbyopia correcting intraocular lenses?
Are there any risks of having presbyopia correcting intraocular lenses?
Why do presbyopia correcting intraocular lenses cost more than conventional implantable lenses?
What are cataracts?
Who gets cataracts?
What are the symptoms of a cataract?
How do I decide to have surgery?
How can cataracts be treated?
Can a cataract return?
What are the benefits of cataract surgery?
Is it still necessary to wear thick glasses after cataract surgery?
How successful is cataract surgery?
Are lasers used to treat cataracts?
What kind of doctor performs cataract surgery?
Will the use of presbyopia correcting intraocular lenses (PCIOLs) give me freedom from glasses?
Yes, for many but not all patients. Many people can read, drive and do other daily tasks without glasses. Most patients can reasonably expect to be far less dependent on reading glasses but may choose to use them for extended periods of reading and working at close distances.
Will PCIOLs give me the same quality of vision I had when I was 20?
No, as with many things, there may be a tradeoff. While you may gain clear vision throughout your visual range, you may experience halos or glare. Most patients find these tradeoffs tolerable, but you should discuss this with your doctor.
How does a presbyopia correcting intraocular lens replace a cataract?
When a cataract forms inside of a natural lens, the natural lens is removed. During the surgical procedure a small incision is made in the side of the eye. The cataract-damaged natural lens is then removed through the incision and the artificial lens is implanted to permanently replace it.
How long after will I have to wait after surgery until I see my best?
In part, this depends on the overall health of your eyes. For most people,
vision usually improves quickly, but most patients require a period of adjustment, perhaps several weeks, as they adapt to the new lenses.
Do multifocal presbyopia correcting intraocular lenses require a period of adjustment?
Yes. Most people require a few weeks for their brain to acquire the habit of “seeing” near and at a distance with new lens. This period can last 6 to 12 weeks.
Will I see glare or halos around lights with multifocal presbyopia correcting intraocular lenses?
Some people experience halos or glare around lights. This diminishes over time for most patients. For some patients, the problem becomes less of a difficulty, but may never go away completely. Again there is a trade off. Most people say that the ability to see near, intermediate and far outweighs visual side effects associated with such lenses.
Are there any risks of having presbyopia correcting intraocular lenses?
All surgical procedures have some degree of risk; fortunately, the risks associated with this kind of surgical procedure are small. The largest risk with any cataract procedure is infection. Less than 1% of patients having a lens implant procedure ever get an infection and most are treated successfully with medications. Infections, in very rare instances,
can cause a severe or total loss of vision.
Why do presbyopia correcting intraocular lenses cost more than conventional implantable lenses?
Patients should know that this technology is very advanced. Moreover, your surgeon must take additional time examining you and perform added tests and calculations. For patients covered by Medicare, the costs of certain parts of the process are covered. The additional cost of the presbyopia correcting lenses and exams must be paid by the patient.
The decision to use presbyopia correcting intraocular lenses is usually made in the context of having cataract surgery. The following portion of this FAQ relates to cataract surgery.
What are cataracts?
- A cataract is an opacification (clouding) of the natural lens inside of the eye. The lens helps us focus on objects at different distances. As a part of the normal aging process, changes in the lens can cause it to become cloudy
- Left untreated, a cataract can become so dense that it causes blindness
- In fact, cataracts are the leading cause of blindness in the world
- The original meaning of "cataract" is “waterfall,” and the name was chosen because distorted vision caused by a cataract reminded people of the distorted view that is obtained when looking through a waterfall
Who gets cataracts?
Cataracts in older people are so common they can be regarded as a normal part of the aging process. Among the major conditions related to cataracts are:
- Individuals older than 60 years
- Individuals suffering from health conditions like diabetes or injury to the eye
- Individuals that use medications such as steroids
- Some cataracts are inherited
In rare cases, congenital cataracts are present at birth. These cataracts are usually related to the mother having German measles, chickenpox or other infectious diseases during pregnancy or to the child having certain syndromes (e.g. Marfan's).
What are the symptoms of a cataract?
- Cloudy, fuzzy, foggy or filmy vision
- Changes in the perception of colors
- Problems driving at night because headlights seem too bright
- Problems with glare from lamps or the sun
- Frequent changes in your eyeglass prescription
- Double vision
These symptoms can also be signs of other eye problems. If you have any of them consult an ophthalmologist for an eye examination.
How do I decide to have surgery?
Most people have plenty of time to decide about cataract surgery. Your doctor cannot make the decision for you, but talking with your doctor can help you decide.
Tell your doctor how your cataract affects your vision and your life. Read the statements below, see which ones apply to you and tell your doctor if:
- I need to drive, but there is too much glare from the sun or headlights
- I do not see well enough to do my best at work
- I do not see well enough to do the things I need to do at home
- I do not see well enough to do things I like to do for example, read, watch TV, sew, hike, play cards and go out with friends
- I am afraid I will bump into something or fall
- As a result of my cataract, I am no longer as independent as I was before I had them
- I cannot see well enough with my glasses
- My eyesight bothers me a lot
You may also have other specific problems you want to discuss with your eye doctor.
How can cataracts be treated?
The natural lens of the eye that has been damaged by a cataract is surgically removed and then replaced with a clear artificial lens. During the surgery, usually done on an outpatient basis, a tiny incision is made in the eye and the cataract-damaged natural lens is removed through the incision. An artificial lens is then inserted through the same incision. Most patients have significantly improved vision after the procedure. For those getting presbyopia correcting intraocular lenses, vision usually improves quickly, but most patients require a period of adjustment, perhaps several weeks, as they adapt to the new lenses.
Can a cataract return?
A cataract cannot return because the entire lens has been removed. However, in as many as half of all people who have
cataract surgery,
the lens capsule, the tissue bag that supports the replacement lens, becomes cloudy. This cloudiness can develop months or years after surgery. It can cause the same vision problems as the original cataract.
Treatment Cloudiness After Cataract Surgery
- A doctor will perform a procedure called a YAG laser capsulotomy
- The doctor uses a laser (light) beam to make a small opening in the capsule which light can pass through unimpeded
- This surgery is painless and does not require a hospital stay
- Most people see well after a YAG capsulotomy
- Your doctor will discuss the risks with you
What are the benefits of cataract surgery?
- Cataract surgery restores quality vision for millions of patients each year
- Good vision is vital to an enjoyable lifestyle
- Numerous research studies show that cataract surgery restores quality–of–life functions including reading, working, moving around, hobbies, safety, self–confidence, independence, daytime and nighttime driving, community and social activities, mental health and overall life satisfaction
Is it still necessary to wear thick glasses after cataract surgery?
No, today cataract patients who have artificial or intraocular lenses (IOLs) implanted during surgery may only need reading glasses for close vision. Patients who do not receive IOLs wear contact lenses for distance vision and reading glasses for close vision. Some patients choose to wear multifocal contact lenses for all distances. In addition, new types of presbyopia correcting artificial, implantable lenses are available. These lenses, discussed above, make it possible for patients to see both near and far, and may reduce or completely eliminate the need for reading glasses.
For many, but not all, patients the use of presbyopia correcting intraocular lenses enables them to read, drive and do other daily tasks without glasses. Most patients can reasonably expect to be far less dependent on reading glasses but may choose to use them for extended periods of reading and working at close distances.
How successful is cataract surgery?
Cataract surgery has a success rate of 98 percent. Continuous innovations in techniques and instruments allow cataract surgeons to treat more patients while keeping costs down and improving quality of patient care.
Are lasers used to treat cataracts?
Generally, no. In some cases, the bag–like capsule membrane that supports the artificial lens that replaces the damaged, cataractous natural lens may become clouded several months after cataract surgery. In that case, a YAG laser may be used to make a clear opening in the lens-containing membrane.
What kind of doctor performs cataract surgery?
Medical doctors, M.D.s, who, after completing medical school and an internship, have had three or more years of special training in eye diseases and surgery, are called “ophthalmologists.” Only ophthalmologists who have had special training in eye surgery are allowed to perform cataract surgery.
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