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Multifocal Lenses Offer Cataract Options

  • February 1, 2006
  • Number of views: 3507
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As you age, the chances are you will develop cataracts. The good news is that cataract surgery, one of the most commonly performed surgical procedures in the country and the most common eye surgery, is relatively safe and usually very effective.

Even better news – new implantable lenses are making cataract surgery more effective than ever for some patients.

A cataract is the clouding of the eye''s natural lens, resulting in hazy or blurred vision. It can be associated with medical problems such as diabetes, injuries to the eye, medication or long-term exposure to bright sunlight. But most cases are simply caused by aging, said Michael Conners, MD, PhD, a Washington University ophthalmologist at Barnes-Jewish Hospital.

Surgery is a good option when a cataract causes vision loss that can''t be corrected with glasses and interferes with normal daily activities, said Dr. Conners, medical director of the Washington University Refractive Surgery Center.

Cataract surgery is done on an outpatient basis with minimal anesthesia.The clouded lens is removed through a tiny incision, usually three millimeters or less, and replaced with a tiny clear plastic implant, called an intraocular lens (IOL). Rarely, the surgeon may have difficulty removing the clouded lens or placing the IOL, but most procedures go smoothly.

"Patients often have the surgery and are home within a few hours," he said.

Though cataract surgery is a low-risk procedure, the complications that can occur include bleeding, infection and rarely, retinal problems. Most of these complications can be remedied, Dr. Conners said.

Usually, recovery is quick and painless and patients are back to most of their normal activities within days.

"The success of routine cataract surgery is excellent," Dr. Conners said. "Patients find their quality of life much improved."

However, some patients find that the standard IOLs are one drawback to the surgery. The IOLs are excellent at restoring a patient''s far vision, fine for driving and other activities. But for reading or computer work or other tasks that require near vision, patients with standard implants usually need glasses.

In the past, cataract patients, most of whom are seniors, accepted the need for glasses. But seniors are more active today than they were decades ago, and many want freedom from having to wear glasses.

For those people, new, FDA-approved IOL technology that gives far, intermediate and near vision without glasses is a "real breakthrough," Dr. Conners said. Three such "multifocal" lens implants are currently on the market.

"People may want to work on their computer or read or do other work without glasses," he said. "These implants provide that freedom."

The procedure to implant these new lenses is identical to the standard procedure, and, as with standard lens implants, complications or side effects are rare. About 10 -20 percent of patients experience glare or halos around lights at night, but that usually subsides within a year, Dr. Conners said.

Patients who have the multifocal lenses report high satisfaction. A recent study showed that 80 percent of patients with the multifocal lenses remained relatively glasses-free at age 70.

But Dr. Conners notes that the multifocal lenses are not for everybody.

"The ideal candidate must be highly motivated to be free of glasses," he said. The lenses aren''t suitable for someone who spends a lot of time on the computer or who does a lot of close work – such as an accountant, proofreader or seamstress. Also, while standard lenses are covered by insurance and Medicare, multifocal lenses are not. Patients must pay out-of-pocket for the lenses.

Finally, some patients find that they aren''t satisfied with the vision the multifocal lenses give them. These patients can always have a LASIK procedure to fine tune their vision or may have the multifocal lenses removed and replaced with standard IOLs, Dr. Conners said.

As one of the most experienced eye surgeons in the area, Dr. Conners notes that multifocal intraocular lens implants are a good choice for certain patients.

"For the right patient, it is an excellent procedure to provide freedom from reading glasses," he said.

For more information on cataracts, cataract surgery and lens options, please call 314-TOP-DOCS (314-867-3627).

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