Presbyopia Correcting Intraocular Lenses (PCIOLs):
Provide distance and near visual function. Offer reduced dependence on glasses and contact lenses and freedom from them altogether for many patients.

There are two types of PCIOLs:

  • Accommodating
  • Multifocal
The most common use of PCIOLs at this time is as an option for cataract patients. As part of cataract surgery, the cataract damaged natural lens is removed and replaced with an intraocular lens. Patients may choose to have a conventional lens, in which case they would need reading or other types of glasses to see both near and far. Or, they can choose a PCIOL. In both cases, the procedure for implanting the lenses are the same.

Click here and then select the videos of the cataract description and cataract surgery.

Clear Lens Exchange
Patients in their middle years whose vision has been degraded by presbyopia can choose a procedure called clear lens exchange.

  • Removes the clear, natural lens and replaces it with an accommodating or multifocal lens.
  • Accommodating and multifocal lenses that are used in this manne are used “off–label,” that is, outside the uses specified by the U.S. Food and Drug Administration (FDA).
  • Patients must be made aware of the nature of the surgery and its risks, benefits and alternatives.
  • Will likely become the dominant vision correction procedure in the future as technology expands.

Advocates of clear lens exchange anticipate that future lens developments will enable them to address all aspects of the patients' visual acuity including nearsightedness, farsightedness, astigmatism, and presbyopia.

Presently there are three artificial implantable presbyopic lenses that are approved for use in the United States by the US Food and Drug Administration (FDA). They are the ReSTOR (Alcon Labs), the ReZOOM (Advanced Medical Optics) and the Crystalens (Eyeonics). Because no single product is perfect for all patients and all situations, patients are strongly advised to consult their eye surgeon regarding their options and what might be most appropriate for their particular needs. However, below is a synopsis of clinical studies for the three products mentioned above. The data for the lenses are difficult to compare, as the study designs and end points are not identical. Furthermore, the data below for the ReSTOR and the CrystaLens are from the US FDA trial investigations, whereas the data for the ReZoom IOL comes from an after market study, as the ReZoom IOL was exempted from FDA trials because it was modeled from a previously approved IOL.

While the data from each of the studies suggest that some percentage of patients do not require glasses, patient satisfaction involves more subtle and complex issues. For example, some patients with these lenses may experience bothersome halos, especially while night driving. Some of these lenses are better at providing near and distance focus without glasses, but not as effective at intermediate distances.

Patient satisfaction is highly individual. There is no single lens that is ideal for every person. Ophthalmologists help patients to decide which lens is best for them, based upon their specific lifestyle needs and personal preferences. To arrive at a proper lens selection, patients must be able to tell their ophthalmologist, in detail, about their life style visual requirements and personal preferences. Through discussion, the patient and ophthalmologist should be able to decide upon a lens, or combination of lenses that will suit the patient's needs. Patients should remember that in addition to the benefit of greater convenience, these lenses involve some trade offs and compromise.
Harris Poll Survey on Vision
The American Society of Cataract and Refractive Surgery recently completed a Harris Interactive Survey of the general population, aged 45 + and patients who have had vision correction surgery to manage presbyopia. See how their experiences match yours. >>