New Cataract Surgery Options
Options for patients needing cataract surgery are expanding quickly. The goal with cataract surgery has long been to get vision as to 20/20 as possible without the use of spectacles. Today, the options have expanded. Here is a brief summary of some of the options now available.
1. Aspheric Mono-focal lenses
This lens only corrects for distance vision but has an improved shape that more closely mimics the human lens, reducing glare and other aberrations which allows for much better quality vision.
2. Toric lenses
These implants correct for distant vision only but are used for patients with large amounts of astigmatism on their corneas. In the past, the only options for addressing the astigmatism portion of a prescriptions was to make an incision directly on the cornea, often leading to scarring or glare problems.
3. Presbyopia-correcting lenses
This is the newest and most advanced class of implants. These implants attempt to provide both distance and near vision improvement. There are two types:
A) Multi-focal/pseudo-accommodative: These implants have optics set up much like a bulls-eye target: the center 'bullseye' region can be for distance or near vision while additional ring moving out form the center has a slightly different power. These implants are somewhat dependent on lighting conditions.
B) Accommodative: Instead of multiple powers built into the implant, these lenses rely on a small change in positions inside the eye, based on the distance of the object we are looking at. These lenses most closely resemble ow the natural human lens works, although the improvement in near vision is not large for many patients.
Contact Lens Material/Design
Si-Hy options are expanding:
There are many brands of Si-Hy lenses to choose from now.
Si-Hy torics expanding:
There are now at least five brands of Si-Hy toric contact lenses, opening the possibility of extended wear to these patients. Besides offering healthier materials, these newer Si-Hy toric lenses tend to fit better, providing better quality vision and comfort.
Multi-focal lens technology:
For everyone over 40, this is the type of contact you will eventually need. The goal of these lenses is to provide help with both distance and near vision. Currently we are seeing about 75-80% of our patients who try multifocals say their vision is good enough to only need mild reading glasses for very small print. Our negative feedback on these lenses is generally one of three things:
- glare at night
- "soft vision" which means the patient can see but nothing is as 'crisp' as their glasses or distance only contacts
- comfort problems as the day progresses
Despite these negative points, the majority of our patients report increased convenience and functionality. Versions of multi-focal contacts in Si-Hy materials are now available with many more options in the near future.
Spectacle Lens Designs
For many years people have complained that progressive lenses (PAL) give good vision but restrict the field of view so much that they just are not practical. PALs provide a gradual change from distance vision to near vision without the 'line' that many associate with 'getting old'. Every year these designs get a little better. We are now at a point where over 90% of our patients who try a PAL design like it )although there is an adaptation period) The price for these new designs stays about the same while the older designs get discounted. Retail chains offer these older designs, which is why they cost so much less.
This is the single-most important technology 'option' on the market. Having this coating put on your lenses provides better clarity (especially in dim lighting), cosmetic improvement, and warranties your lenses for up to two years against scratching and chipping. The newer versions are also much easier to keep clean. Some insurance plans cover anti-reflective coatings, most provide at least a discount. The main purpose of this technology is to prevent light from bouncing off your lenses and to help light pass through the lenses more efficiently. This is one of the enhancements used in modern telescopes and microscopes to provide better optics. If you do only one thing to 'upgrade' your lenses, this should be the option.