Cataract Surgery Lens Options: Choosing the Right Artificial Lens for You

Choosing an artificial lens before cataract surgery is an important consideration because your choice will ultimately impact your vision for the rest of your life. There are more than a few options to choose from when selecting an artificial lens as part of your treatment for cataracts. 

When making this decision, it’s important to factor in your lifestyle, your goals, and your budget. It’s also important to understand all of your options in order to make the most informed decision possible.

Types of Artificial Lenses

During cataract surgery, an individual’s cloudy eye lens is removed and replaced with an artificial lens, also called an intraocular lens (IOL). Recent advances in IOLs and the materials used give patients the opportunity to correct a variety of vision problems.

When making an informed decision regarding the type of lens, it’s important to consider lifestyle and budget. Your ophthalmologist will guide you in this decision-making process.

Types of artificial lenses to choose from include monofocal lenses, multifocal lenses, extended-depth-of-focus IOLs, and toric lenses. 

Monofocal Lenses

These types of lenses are made for a single distance. Most individuals have IOLs calibrated for distance vision and opt to use reading glasses in situations where near vision is needed.

Insurance generally covers the cost of this IOL, as it is considered a standard lens.

Multifocal Lenses

These types of lenses feature built-in corrective zones and are comparable to bifocal and trifocal glasses. This allows individuals to see objects that are both near and far away. Some multifocal lenses also have the ability to correct vision. 

Insurance may not cover the cost of this lens, as it is considered a premium lens. You’ll have to pay the difference in cost out of pocket.

Extended Depth of Focus (EDOF)

Like monofocal lenses, EDOF lenses have a single corrective zone. However, the corrective zone can be stretched to accommodate both long and intermediate distances. 

This is also generally considered a premium lens by insurance companies.

Accommodative Lenses 

These types of lenses can correct vision problems at all distances by utilizing natural movements of the eye to change lens focus. This is a premium lens.

Toric Lenses

Toric lenses are usually used for astigmatism and feature built-in vision correction.

Presbyopia-Correcting Lenses

Presbyopia-correcting IOL implants have the ability to correct nearsightedness and/or farsightedness.

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IOL Benefits

Intraocular lenses have been around since the 1940s. IOLs were actually the first implants to be inserted into the human body. They are designed to last a patient’s lifetime and remain in the eye. 

IOLs improve vision and in some cases can correct refractive errors. IOLs can assist in correcting astigmatism and can also help to protect the eye from UV ray exposure. 

IOLs can also be customized for ocular needs, so each patient can get custom-tailored lenses for their particular requirements.

How to Choose the Right Lens

Choosing the right lens for your cataract surgery comes down to the individual’s needs. For instance, if you already wear reading glasses and plan to in the future, monofocal lenses might be the appropriate choice for you. In cases where an individual has astigmatism, toric lenses might be the best choice for them. 

For those who do not wish to wear glasses after surgery, presbyopia-correcting lenses would likely be the most suitable option. Factors to consider are lifestyle and current eye condition. 

Talk to your cataract surgeon about what you hope to accomplish with your surgery. They will likely recommend the best lens for your situation.

Insurance Coverage

Deciding which lenses are right for you may come down to insurance coverage. While monofocal lenses are generally fully covered under many insurance plans, toric and presbyopia-correcting lenses are generally not covered by insurance. 

Certain types of lenses will come with an additional out-of-pocket expense. Patients can expect to pay around $1,000 to $3,000 per eye, depending on the lens needed.

Medicare health insurance will generally cover the cost of extraction of cataracts, monofocal lens and implantation, and one pair of either prescription glasses or contact lenses. Premium lenses have been shown to improve reading and nighttime driving, but they are generally not covered by insurance providers. You can pay the difference out of pocket, as insurance will usually still reimburse you for the cost of standard monofocal lenses.

Additional IOL Considerations

It’s important to consider your budget and your short-term and long-term goals when selecting your IOL. 

The cost for surgery and implant can often range anywhere from $2,500 to $5,000 or more. However, your budget should not be the sole determining factor. If your insurance provider does not cover your lenses, your chosen clinic may provide you with financing options that suit your needs and allow you to get the lenses you want. 

If you frequently drive at night, certain side effects from IOLs will impact you more, so this should be considered in your decision-making process. Likewise, if you do a lot of up-close work, this will be a major factor to consider. 

If you have certain conditions, such as macular degeneration or glaucoma, certain types of lenses may not be ideal for you. Generally, multifocal IOLs and EDOF lenses are not recommended for people with these conditions.

Bring all these issues up with your surgeon. They are in the best position to help you make the decision on the ideal artificial lens for your cataract surgery.

References

1. Recent Advances of Intraocular Lens Materials and Surface Modification in Cataract Surgery. (June 2022). Frontiers in Bioengineering and Biotechnology.

2. Impact of Material and Lens Design on Repositioning Surgery of Toric Intraocular Lenses: A Single-Arm Meta-Analysis. (January 2022). Journal of Ophthalmology.

3. Real-World Cataract Surgery Complications and Secondary Interventions Incidence Rates: An Analysis of US Medicare Claims Database. (April 2022). Journal of Ophthalmology.

4. Nondiffractive Wavefront-Shaping Extended Depth-of-Focus Intraocular Lens: Visual Performance and Patient-Reported Outcomes. (February 2022). Journal of Cataract & Refractive Surgery.

5. Factors to Consider in Choosing an IOL for Cataract Surgery. (December 2022). American Academy of Ophthalmology.

6. Choose the Right Artificial Lens for Your Cataract Surgery. (July 2021). Duke University.

7. Which Intraocular Lens Would Ophthalmologists Choose for Themselves? (October 2019). Eye: The Scientific Journal of the Royal College of Ophthalmologists.

8. Choosing Intraocular Lenses in Patients Undergoing Bilateral Cataract Extraction—One Size Does Not Fit All. (September 2022). JAMA Ophthalmology.

9. Matching the Patient to the Intraocular Lens. (November 2021). Ophthalmology.