Which Patients are Good Candidates for Premium IOL

Premium IOLs or intraocular lenses are lenses that are placed in the eye during cataract surgery. The lens placement is designed to restore the natural lens shape. These lenses can also be placed as a vision correction device called refractive lens exchange. Premium IOLs offer advanced features beyond the single vision IOL’s that are also offered. These features include aspheric, toric, accommodating, and multifocal IOL’s.

Understanding Premium IOL Types

Aspheric Lenses

These lenses closely match the natural curve of the eye. Typical lenses were uniformly curved making it easier to manufacture, but at the same time increasing the chance of causing imperfections in vision. Aspheric lenses help to reduce imperfections and improve clarity, especially at nighttime.

Toric IOLs

These lenses are specifically designed to help correct nearsightedness, farsightedness, and astigmatism.

Accommodating IOLs

Accommodating IOL’s can tilt slightly forward when you look at objects that are close to the eye. This helps to improve visibility when you are performing actions like reading a book. While they are not necessarily as sharp as bifocals, patients have a reduced need to use reading glasses while still maintaining excellent distance vision.

Multifocal IOLs

If you require a bifocal or trifocal lens in your glasses, this may be a likely choice for you. Different portions of the lens allow for better vision at different ranges. However, there are some overall sacrifices with vision clarity at a distance.

History of Premium IOLs

Premium IOLs have been approved by the Food and Drug Administration (FDA) since the 1980s. Prior to FDA approval, when patients had cataract surgery, they were required to wear very thick eyeglasses or specialized contact lenses to correct their vision. New technologies in the optical world have allowed for a wide variety of available premium IOLs and figuring out which specific type that suits you best will depend on some different factors.

Patient Factors

Physicians are careful to discuss the realities of this procedure with their patients. After recovering from cataract surgery, many patients expect that their vision will be completely restored to their peak performance. However, doctors are careful to warn against this and explain the realities of the surgery and as well as likely expectations of what will result from the surgery. For this reason, surgeons are likely to have some initial concern about the desired outcome for the patient to make sure that their hopes are grounded.

Surgeons will also have an eye toward the patient's desire to not wear eyeglasses. If the patient does not mind wearing corrective lenses without the need for surgery, this may be the best option. These lenses may also not be an ideal fit for the elderly population. Eyes in the geriatric population are often rapidly deteriorating requiring a lens replacement more quickly than would be recommended.

Patients with certain medical histories may also be poor candidates for premium IOL surgery. Some of these conditions include:

Advanced macular degeneration
Anterior basement membrane dystrophy
Fuch’s dystrophy
Weak zonules
Glaucoma
Post-refractive surgery patients

This list is not comprehensive, so it’s important to consult with your physician and bring a detailed medical history for their review.

Finally, patients may also want to consider their careers when weighing the value of this surgery. Patients who are required to read on computer screens for extended periods of time (i.e., print editors, office jobs) may be ideal candidates.

In contrast, individuals that require long-distance acuity like truck drivers, pilots, or even photographers may find that some of the issues with these lenses are not suited to their needs. Individuals often complain of “halos” during the night when looking toward a light, glare, or general acuity issues at longer distances.

Further Consideration

While premium IOLs do have some limitations, they offer an excellent choice for many individuals. However, it is important to meet with your eye care professional to fully discuss all of the available options to find your best fit as well as to make sure that you understand all of the potential risks and restrictions that this operation poses.