Cataract Surgery Lens Options

5 min read

Developing a cataract in both eyes is a normal part of aging. Because of this, cataract surgery is the most commonly performed surgery across the world. In order to see clearly after cataract surgery, the ophthalmologist must place an artificial lens inside the eye. This is because the natural lens of the eye is removed during cataract surgery. Most patients who have surgery for cataracts will have an artificial lens placed inside the eye. There are many choices when it comes to cataract lens options. Because each patient is different in their needs and their lifestyle, the best lens for cataract surgery may be different for different people.

Toric Lens

If you are a patient with a high level of astigmatism, the best cataract lens for astigmatism is a toric lens. Toric lenses for cataract surgery correct both the sphere part of a prescription as well as an astigmatic component to your prescription. If you are looking at your glasses prescription you will see 3 numbers if you have astigmatism. Here is an example: -2.00-3.00 x 90. In this example the -2.00 is the sphere correction and the -3.00 is the cylinder or astigmatism correction. The number 90 is the axis of the astigmatism, and it is a number between 1 and 180. Astigmatism prescriptions always have an axis associated with it. This axis helps the cataract surgeon to determine the position that the toric lens must be placed in during cataract surgery. Cataract surgery with toric lenses is typically not fully covered by insurance. Usually a patient's insurance will pay for the cataract surgery and a basic lens, but not an upgraded toric lens. Depending on the degree of your astigmatism, a toric lens may be a very worthwhile upgrade for you, and may give you the ability to see clearly in the distance without a pair of glasses.

Multifocal Lens For Cataract Surgery

Typically vision after cataract surgery will be clear for distance vision, but not for up close or reading. When having the discussion on lens options for cataract surgery, it is important to know that the lens you choose has an affect on this. Multifocal lenses are a great option for many patients who do not want to wear reading glasses after having cataract surgery. Multifocal lenses, as the name implies, allows a patient to focus at multiple distances. Not every patient tolerates multifocal lenses, so it is important to make an informed decision with your ophthalmologist. These lenses are also usually not covered by insurance. Insurance will usually cover the cost of basic surgery but not the upgrade in the lens.

Standard Lens

The standard lens for cataract surgery is usually covered by insurance. If you do not have a high level of astigmatism and are willing to wear reading glasses after cataract surgery, this may be the right option for you. A standard lens in cataract surgery will correct the sphere part of a patient's prescription, which in the example above is the -2.00 number. Toric lenses will correct both the sphere and cylinder (astigmatism) correction.

How Long Does Cataract Surgery Take?

In general, cataract surgery is very quick and takes, on average, 20 minutes. If you have a very dense lens, it may take longer, or if you have a very soft lens it could be shorter than 20 minutes. The answer to this question more specifically depends on a few other factors including the lens choice. If you are choosing a lens that is toric, the surgeon will need to ensure that the toric lens is placed at the correct axis. The marking of the eye and the rotation of the lens to the correct position could take an extra couple minutes.

In some cases, a cataract surgeon will advise you to have cataract with laser. The laser allows for more precision in the first part of the cataract surgery. The surgery can not be done entirely by laser, but it may be a good option for certain patients. If you have laser assisted cataract surgery, then the procedure could take a few extra minutes since you will need to be moved from one machine which does the laser to then the operating scope where the surgeon will complete the surgery.

If you are having an additional procedure, such as a glaucoma procedure, alongside cataract surgery, this could add anywhere from 10 minutes to an hour to your cataract surgery time. Ask your doctor what they anticipate the operating time to be.

Cataract Surgery Lens Options: Take Home Points

The general options for choosing a lens in cataract surgery vary between those covered by insurance and those that are not. If you have a strong astigmatism prescription, consider an upgrade to toric lens to help you see clearly. If you want to see clearly at all distances after your surgery, choose a multifocal lens. Always remember to discuss the details with your ophthalmic surgeon since each case is different.

Sources:

Sachdev MS. Commentary: Toric intraocular lens alignment: Going markerless. Indian J Ophthalmol. 2020 Apr;68(4):587-588. doi: 10.4103/ijo.IJO_1877_19. PMID: 32174574; PMCID: PMC7210851.

https://pubmed.ncbi.nlm.nih.gov/32174574/

Zhou F, Jiang W, Lin Z, Li X, Li J, Lin H, Chen W, Wang Q. Comparative meta-analysis of toric intraocular lens alignment accuracy in cataract patients: Image-guided system versus manual marking. J Cataract Refract Surg. 2019 Sep;45(9):1340-1345. doi: 10.1016/j.jcrs.2019.03.030. PMID: 31470944.

https://pubmed.ncbi.nlm.nih.gov/31470944/

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