Choose the Right Artificial Lens for Your Cataract Surgery

By Larissa Biggers

Cataract surgery involves removing a clouded lens and replacing it with an artificial intraocular lens (also called an IOL) to improve your vision. However, not all IOLs are the same. Some can help you see near or far even better. Choosing the right lens for you can be confusing. Here, Duke corneal specialist, Terry Kim, MD, explains your options.

What Are My Intraocular Lens Options?

You have a one-time opportunity to select the lens that's going to give you the best possible vision and improve your quality of life. It’s important for your doctor to explain all the options so you can make the best choice for you.  

  • Monofocal lenses correct your vision for distance or for near. You decide which is more important to you. For instance, you may want to correct your distant vision so you can drive without glasses but wear glasses for near work. If you are an artist or a dentist, you might choose to improve your near vision and wear glasses for distance. 
  • Toric lenses reduce your astigmatism to help improve the quality of your vision. 
  • Presbyopia-correcting lenses (also called multi-focal or extended depth-of-focus lenses) correct both near and far vision. For many people, this means depending less on distance glasses and reading glasses after cataract surgery.

Which Lens Is Right for Me?

That depends on your needs. If you’re comfortable wearing glasses after cataract surgery, a monofocal lens may be the right choice. If you want to avoid wearing distance glasses after cataract surgery and have astigmatism, a toric lens might be appropriate. A presbyopia-correcting lens may be best if you want to avoid wearing distance and reading glasses after cataract surgery. It all comes down to what you want in terms of improving your eyesight and lifestyle.

Are All IOLs Covered by Insurance?

Monofocal lenses are fully covered. Toric lenses and presbyopia-correcting lens are not covered by insurance. You will pay an additional out-of-pocket expense -- around $1000 per eye for toric and between $2000 and $2600 per eye for presbyopia-correcting lenses -- if you choose one of these IOLs.

How Long Does Vision Correction Last?

Vision correction achieved with cataract surgery is permanent.

Is the Surgery Performed Differently Based on the Type of Lens you Choose?

Cataract surgery is the same no matter which IOL you select, but surgeons can use one of two approaches. 

  • In traditional cataract surgery, your eye surgeon uses a thin blade to make incisions in your eye, removes the cataract, and replaces it with the artificial lens. 
  • In laser-assisted cataract surgery, the surgeon uses a laser to make the incisions and correct astigmatism.  This surgical procedure may be more precise than traditional cataract surgery.   The surgeon then removes the cataract and replaces it with the artificial lens. Laser-assisted surgery can also reduce astigmatism, which is harder to achieve with traditional surgery. It’s important to note that insurance plans don’t cover laser surgery for cataracts.

What Should People Know when Considering Cataract Surgery?

It’s important for you to spend one-on-one time with your eye surgeon before the procedure. Your surgeon should explain the surgical procedure and your lens options. Understanding your choices is the only way you can make an informed decision.

Article originally appeared in Duke Health

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