About Multifocal Lenses (Symfony, Restor, and Tecnis)
What makes multifocal lenses different from other lenses?
A multifocal IOL provides focus points at varying distances, providing sharper vision without corrective lenses throughout a full range of vision from near to far.
Standard (single vision) monofocal lens implants do not have the ability to provide a full range of vision. Most people who have single vision lens implants MUST wear glasses for middle and near vision.
Can my vision be corrected to 20/20?
Amultifocal IOL has been designed to focus your eyes at all distances after cataract surgery. While virtually everyone will experience a significant improvement in their uncorrected vision after surgery some people will not see 20/20 at all distances.
Many people who have not had surgery, are not able to see 20/20 at both near and far even with glasses or contact lenses. This is due to a variety of ocular and physiological problems as well as lifestyle preferences, yet most of these people function quite normally despite this reduction in their vision.
The clinical results formultifocal lenses indicate that over 90% of people never wear glasses for distance tasks, and about 80% of these same patients never wear glasses for near vision tasks.
Will I be able to read in all light conditions?
Amultifocal lens functions very much like the normal human lens. It is important to remember that reading vision in low light is also influenced by the overall health of your eye and by the condition of the light sensors in the retina. As we get older, our ability to see in low light conditions may start to decrease. It is always best to read in good light conditions.
How do I know if I am a good candidate for a Multifocal?
Our doctors will perform a thorough examination and advise you of a customized treatment plan for correcting your vision. Almost everyone with good health is a candidate for implant surgery, but people with chronic infections, diabetes, or other problems may have to wait until these conditions are under control prior to surgery.
Should I have a multifocal lens put in both eyes?
Typically cataracts will develop in both eyes. If only one eye has a cataract, only one implant is necessary. If both eyes have cataracts and the vision in one eye is worse, your surgeon will generally elect to implant that eye first. If both eyes are the same, he usually starts with the ‘non-dominant’ eye. Our doctors will look at a number of factors in deciding which eye to implant first.
How long will the surgery take?
The ReSTOR® procedures are typically performed in an outpatient surgical facility. You will arrive at the surgery center about an hour before the procedure. A number of topical drops will be placed in your eye and oral medications may be administered to help you relax. The eye drops anesthetize your eye and dilate your pupil.
Once in surgery, you will lie down, a microscope will be positioned over your eye and you will be asked to look up into the light of the microscope.
The actual surgery usually takes less than 20 minutes. Your surgeon will stabilize your eye with a device to keep your eyelids open. You will feel no pain, only slight pressure on your eye. Upon completion, additional drops will be placed in your eye to prevent infection, decrease inflammation, and keep your pupil dilated. A patch may be placed over your eye and someone will need to drive you home. When you are at home, you should rest for the remainder of the day. You should avoid any strenuous activities. We will see you the day after surgery to remove the eye patch and examine your eye. Do not rub your eye.
You will be given additional medications that you will need to put in your eye for the next week or two. These drugs help the eye heal leaving no residual effects.
What are the chances that something could go wrong with the surgery? What would they be?
The contemporary treatment for cataracts is to remove the crystalline lens and replace it with an artificial lens.
The medical procedure to implant amultifocal lens is the same safe, proven cataract surgery performed annually on over 7 million eyes globally. Over 40 million procedures have been done in the last 25 years. It is important to note, like any surgery, it is not completely risk-free.
When will I be able to return to normal activities?
You will be able to return to normal activities within several days after implantation with some limitations. Your eye may be sensitive to touch and bright light, but you should be able to drive and return to work in two to three days.
Your doctor will provide you with medications to prevent infection and decrease inflammation, and may provide a protective shield to cover your eye while sleeping. A pair of plastic, disposable sunglasses will decrease your sensitivity to light as well as providing protection during the day.
It is important that you avoid heavy lifting or straining that would increase the pressure in your eye for several days after surgery. You also must avoid rubbing or pushing on your eye. You should refrain from activities that could increase your chances of getting hit in the eye. Wear your protective sunglasses when outdoors.
You can shower and wash your hair as long as you avoid getting soap or shampoo in your eye. Refrain from using eye makeup, lid liner and mascara for several weeks after implantation. You should avoid public swimming pools, hot tubs or other sources of bacterial contamination for several weeks.
Consult your surgeon on recommendations for specific activities.
How often do I need to have my eyes checked after surgery?
Typically, we will see you one day after surgery, after 2 to 4 weeks, and again around 3 to 6 months after surgery. Thereafter, an annual exam is usually sufficient unless you have a specific problem.
Will I have to have cataract surgery again?
Once your cataracts are removed and replaced with an artificial lens, you will never have to have cataract surgery again. Occasionally, several months after the lens has been placed in the eye, the vision may start to become cloudy once again. This is sometimes called a secondary cataract and refers to the clouding of the membrane that surrounds the implant.
This membrane (the capsular bag) originally surrounded the human lens. When the cataract was removed, all that remained was this membrane into which the artificial lens was implanted. The membrane healed around the artificial lens, securely holding it in place in the eye. Unfortunately, sometimes the same conditions that caused the original cataract will cause the build up of cells on the membrane behind the implant. These cells will block the vision and have to be removed.
A laser is used to make an opening in the membrane behind the implant, immediately improving vision. This is done painlessly without an anesthetic and takes just a few minutes. Once this is done no further surgery related to your cataracts will be required.
What happens if my eye is injured sometime in the future?
Eye injury can involve many different parts of the eye. The clear front part of the eye, the cornea, and the back part of the eye, the retina, are most often affected by injury.
The presence of an artificial lens does not make the eye any more vulnerable to trauma. Indeed, once the human lens has been replaced, eye trauma would not cause a cataract.
What about future eye surgery?
Since the implant is fixed in the same position as the original lens, any future eye surgery that could be performed in or around the normal eye can be performed in an eye with amultifocal lens.
BOTOX® treatments, plastic surgery, pterygium removal and other cosmetic procedures should not be performed until your eye is well healed. Typically this is around 3 months, but your doctor will advise you when it will be safe to undergo these procedures.
I have dry eyes. Will lens implantation help this condition or will I still have to use artificial tears?
Implant surgery typically will have very little influence on chronic dry eyes. This condition is related to a variety of internal and external medical conditions and is sometime associated with aging. You should consult your surgeon on a therapy that is most suited to the cause and severity of your condition as well as your lifestyle.
Will cataract surgery influence chronic red and irritated eyes or headaches from eyestrain?
If eye irritation is a result of excessive contact lens wear, sensitivity to cleaning and storage solutions, or what is generally described as ‘eye strain’, implant surgery may reduce or eliminate these symptoms. Eye irritation can be caused by a wide variety of internal and external factors including allergies that have nothing to do with the lens implant.
What will a multifocal procedure cost? Will insurance cover any of it?
If you have a cataract, your Medicare or private insurance may cover the cataract surgical procedure and anesthesia; and may also allow a certain additional amount for the lens implant. You are then required to pay a deductible as well as any additional amount above the primary coverage. (Some patients are completely responsible for payment – not all insurance companies will cover cataract surgery).
If you do not have a cataract, but wish to have the multifocal lens implanted to improve your distance and near vision, the procedure is viewed as elective by Medicare and private insurance companies.