Intraocular Lens Options
An intraocular lens (IOL) works by replacing the focusing power of your eye’s natural lens. Today’s IOL technology can give you better vision – often without glasses – than before cataract surgery. Dr. Legare thoroughly evaluates your eyes before recommending a particular IOL. We’ll talk about your work, hobbies and other activities to make sure your IOL choice fits your lifestyle.
How is the artificial lens different from my natural lens?
Under the age of about 40, the lens is very flexible and can focus at various distances. After the age of 40, the lens becomes less flexible, and it slowly loses the ability to focus from far to near. This condition is called presbyopia. Reading glasses become necessary (for people who normally see well in distance without glasses) or bifocals (for people who need eyeglasses to see in the distance).
The standard IOL, in contrast, is a semi-rigid, lens that has a fixed curvature. It cannot change its shape or position in the eye. Therefore, it cannot focus at various distances without the aid of glasses. Thus, if the IOL is chosen to help you see in the distance, you will not be able to see near without glasses. And if the IOL is chosen to help you see near, you will have to wear glasses to see in the distance.
There are other lens options that address these limitations, but these are not covered by any insurance plans.
Lens options and what can I expect depending on what I choose?
You have different options for intraocular lens implants, depending on your needs and the health of your eye.
Standard IOLs (Single-focus)
For those with mild to no astigmatism, standard IOLs will give you sharp, clear focusing power at a single distance, either close up (near vision) or far away (distance vision). They are also called single-focus or monofocal IOLs.
The conventional or standard monofocal lens has one focal point. You will still need eyeglasses to see clearly at some or all distances. For instance, if you want to see in the distance well, then you will need glasses to see well at reading and computer distance. If you want to see better possibly without glasses for reading, then you will need to wear glasses in the distance and at computer distance.
You might choose one IOL for near vision and one for distance. This is called monovision. Dr. Legare will help you select the best option specific to your needs.
Does insurance cover standard IOLs?
Yes. When cataracts are advanced enough that surgery is considered medically necessary, health insurance (including Medicare) covers cataract surgery and standard IOLs.
Toric IOLs
A second type of monofocal lens called a Toric IOL corrects for astigmatism. Astigmatism is an irregular shape of the cornea. Uncorrected astigmatism causes objects to look distorted or create multiple images. If you have significant astigmatism, placing a toric lens can correct your astigmatism so that can see better at all distances compared to a standard lens. However, you may still need to use glasses, especially for reading. If you are able to see well in the distance without glasses, then you will still need glasses to see for reading and intermediate distances (computer). You might be able to use over-the-counter reading glasses, instead of prescription glasses.
Does insurance cover the upgrade to a toric IOL?
No. Health insurance (including Medicare) covers cataract surgery with standard IOLs when your cataracts are advanced enough that surgery is considered medically necessary. Toric IOLs offer the convenience of improving your vision without glasses after surgery. Insurance companies don’t consider this benefit a medical necessity, so they do not cover the upgrade. They do cover the cost of surgery if cataract removal is medically necessary.
If you choose a toric IOL, we ask that you pay for your premium IOL in advance. This is because the implant must be ordered before surgery in your chosen focusing range. Your advance payment covers this cost.
Multifocal IOLs
A multifocal lens is a presbyopia-correcting lens that will allow you to see at “multiple focal points,” so you can see at different distances without glasses. Although there is no guarantee that you will read as well without glasses as you desire, multifocal lenses give you a higher chance of doing so compared to the standard monofocal lens.
There is some risk of seeing haloes or decreased contrast sensitivity (the ability to distinguish between an object and a similar background).
The benefit of a multifocal lens is that it may decrease your dependence on glasses. Some find that the increase in range of vision outweighs the disadvantages, but you will have to make that decision.
Does insurance cover the upgrade to a multifocal IOL?
No. Health insurance (including Medicare) covers cataract surgery with standard IOLs when your cataracts are advanced enough that surgery is considered medically necessary.
Multifocal IOLs offer the added convenience of reduced dependence on glasses after surgery. Insurance companies don’t consider this benefit a medical necessity, so they do not cover the upgrade to a premium IOL. They do cover the cost of surgery if cataract removal is medically necessary.
If you choose a multifocal implant, we request that you pay for your premium IOL in advance. This is because the implant must be ordered before surgery in your specific focusing power. Your advance payment covers this cost.
The Right Lens for You
Because your eyes are so important for everything you do, selecting an IOL is a very personal decision. At Mt. Pleasant Eye Surgeons, we will spend the needed time with you to help you consider all your options.