Premium Intraocular Lenses (IOLs) / ReStor, Crystalens, Toric

Yes.  There are two main categories: traditional and premium.  The traditional IOL is a monofocal lens which gives clear vision at one fixed distance.  Patients who have a traditional IOL implanted usually see well at distance without corrective lenses but need reading glasses to see clearly up close.

Premium IOLs correct factors affecting vision such as astigmatism (irregular curve of the eye) and presbyopia (the need for reading glasses) which are not corrected by traditional IOLs.  The result is patients with a premium IOL have much greater freedom from glasses and/or contact lenses than a patient with a traditional IOL.

The two main categories are: astigmatism correcting (toric) and presbyopia correcting.

A Toric IOL is designed to correct astigmatism.  Astigmatism is a factor in some patients’ prescriptions that causes additional blur and distortion.  In most cases, it is due to the particular curve of an individual’s cornea; this is called corneal astigmatism.  

Prior to cataract surgery, astigmatism is usually corrected with glasses, contact lenses, or laser / LASIK^®.  After cataract surgery with a traditional IOL, patients with astigmatism would still need glasses or contact lenses to see clearly at all distances. 

The advantage of the toric IOL is that corneal astigmatism is addressed at the time of cataract surgery.  Therefore, patients with a toric IOL implanted would typically only need help from corrective lenses  for  near vision, with something as straightforward as reading glasses / magnifiers. 

There is a limit to the amount of astigmatism a toric IOL can correct, and for patients with a very significant amount of astigmatism, other treatments such as laser or incisional surgery are combined with the toric IOL to reduce astigmatism.

There are two sub-categories: multifocal and accommodative.  Both give patients clear vision at distance, intermediate, and near.  This advanced technology is vastly increasing the freedom from glasses for cataract patients. 

A patient with a presbyopia correcting IOL could potentially engage in a variety of activities such as seeing street signs, looking at a computer screen, and reading a book without needing glasses for any of them.

A multifocal IOL has rings of different corrective power built into the lens.  These rings help keep light and images from all distances in focus.  One of the most commonly used multifocal IOLs is the AcrySof ReSTOR.

An accommodative IOL has flex points or hinges to allow the lens to move in coordination with the muscles of the eye to provide clear vision at all distances.  The most common type of accommodative IOL is the Crystalens HD.

No; with “never” being the key word.  As discussed above, patients with a toric IOL for astigmatism will still need glasses for reading.  A patient with a presbyopia correcting IOL is expected to see most things at all distances clearly, but may still need glasses or contact lenses depending on the specific task or lighting conditions.

Partially.  Patients who choose to have a premium IOL implanted receive the same amount of insurance coverage for the surgical portion of the cataract operation as a patient selecting a traditional IOL.  However, the advanced technology and vision correction of a premium IOL is considered elective, and therefore, there is an out of pocket charge.  This fee is for the lens itself, and the additional testing and counseling involved with premium IOLs.