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The Alcon ReSTOR, Alcon Toric, AMO TECNIS, and B&L CrystaLens, premium lens implants are just a few of the options available at Harvard Eye Associates to improve the quality of your vision after cataract or refractive lens implant surgery.
Especially exciting are the latest lens implants that can provide both reading and distance vision without glasses. For 50 years, eye surgeons have used lens implants to replace the eye's internal focusing lens, but until recently every lens implant acted simply like a fixed-focus lens. Three new lens implants have been FDA-approved recently for correction of both distance and reading vision.
Each of these implants works slightly differently, and not all implants are right for all patients. This page is designed to help people interested in these new-technology lens implants to understand the similarities and differences between them. Our eye surgeons have extensive experience implanting all of the lenses described here and are take pride in helping each patient make an unbiased, informed decision on an implant that will provide a lifetime of clear vision.
|Focusing Mechanism||Light focuses through diffractive rings providing a distinct near and distant focus.||Implant moves back and forth (auto-focus), powered by your eye muscles.||Light focuses through a unique "apodized" lens shape, giving far and near focusing.|
|Distance vision (road signs, TV captions)||+++||+++||+++|
|Arm's length vision at 2-3 feet (computer screen)||++||+++||++|
|Near Vision at 1-2 feet||+++||++||+++|
|Clarity for driving at night||+++||+++||++|
|Slowly improves over several weeks.||Slowly improves over one to several weeks.||Slowly improves over one to several weeks.|
|Immediate.||Slowly improves over one to several weeks.||Immediate.|
|Advantages||Excellent results for distance and near.||True accommodating lens. Theoretically best clarity of vision.||Best for fine print. Results are immediate.|
|Disadvantages||May get mild haloes when driving at night. 10% of Patients may need glasses.||Some "learning curve" in retraining muscles to focus. May need glasses for reading||May get mild haloes when driving at night. May need glasses for arms length vision (e.g., computer)|
|Ideal Candidate||People who desire less dependence on glasses. 90% of Tecnis patients use NO glasses at all!||Active people who may not mind glasses for very fine print. People who need clear vision for driving at night.||People who drive minimally at night or are not bothered by glare. People who spend a great deal of time reading and do not mind wearing glasses for computer use.|
The ReSTOR lens is a non-moving lens implant. It can give distance and near vision simultaneously.
Rather than having three separate focusing zones like TECNIS, however, the ReSTOR lens focuses vision using an "apodized" surface. This high-tech manufacturing process gives the lens a gradual blending of focusing power throughout the entire lens surface.
With the ReSTOR lens, 97% of people can see both distance objects (road signs) and near objects (reading material within 1-2 feet) without difficulty, especially in good light. Arms length vision (the computer screen, for example) at 2-3 feet is less clear, and most people will need glasses for these kinds of tasks. In dim light, the lens is designed to give better distance vision. However, 5% of people with ReSTOR do notice significant haloes or glare around lights at night. READ MORE about the ReSTOR Lens.
The Alcon AcrySof Toric lens implant is designed to correct astigmatism. For cataract patients that have astigmatism and do not want to be dependent on glasses after cataract surgery, a Toric Lens Implant can be a solution. The Alcon AcrySof Toric lens corrects both conditions simultaneously, resulting in significantly better visual outcomes. The Alcon AcrySof Toric lens implant does not correct presbyopia, so reading glasses or bifocals may still be needed to comfortable perform near vision tasks such as reading, or computer work.
If you are considering cataract surgery and have astigmatism then the Alcon AcrySof Toric lens implant might be right for you. Talk to your Harvard Eye doctor for more information and to find out if the Alcon AcrySof Toric lens is the right option for you.
The Tecnis Multifocal IOL is based on the aspheric optic design of the Tecnis IOL (Abbott Medical Optics, Inc.), which was engineered to reduce the spherical aberration of an average cornea (which enhances clarity). Based on a principle of diffraction the Tecnis Multifocal IOL features diffractive rings on its posterior surface.
The rings start very close to the optics center and then continue out toward the periphery. As a result, the multifocal effects are not affected by pupil size or lighting conditions. Even in dim light, distance and near vision is quite good. The lens provides patients with excellent near and distance vision, each of which is distinct. Most patients also report good intermediate or arms' length vision as well.
Immediately after surgery, some patients may notice haloes around lights
when driving at night. However, as the eye adjusts to the lens, the visual impression of rings
may lessen and usually goes away over time.
READ MORE about the TECNIS lens.
The most recent addition to the TECNIS® IOL family is the TECNIS® Toric. This toric lens provides the recipient with astigmatism correction with cataract surgery, meaning the patient will see a greater number of visual impairments removed after their procedure.
There are a number of ways to correct astigmatism during cataract surgery, including limbal relaxing incisions. The TECNIS® Toric uses the biocompatible materials and multifocal design employed in every TECNIS® Multifocal IOL, and provides the added benefit of astigmatism correction without any additional surgical steps.
If you're a cataract patient interested in premium lens implants, including the potential to have great vision without the need for glasses after surgery, then ask Harvard Eye Associates about the TECNIS® Toric lens.
The CrystaLens implant can give reading vision (within 1-2 feet), arm's length (2-3 feet), and distance vision without glasses because this implant actually adjusts its position within the eye as the eye looks from far to near subjects, much like an 'auto focus' mechanism on a camera. The CrystaLens is powered by the same ciliary body muscles that move and focus the eye's own natural lens. Its unique, hinged shape allows for this lens movement and gives a seamless transition from far to arm's length to near vision. Most people with the CrystaLens have clear far vision (driving, television) and intermediate vision (arm's length, computer screen) without any glasses. About 95% of people can also read newsprint without glasses. Some people do need glasses for fine print, especially in dim light. Of the three lenses, the CrystaLens is most likely to provide the best vision for driving at night.
Almost everyone will develop cataracts during their life. Cataracts occur when the crystalline lens of the eye becomes cloudy, forming an off-white haze, which leads to blurring of vision, yellowing of colors, glare, haloes, and several other symptoms. The formation of cataracts is a gradual process that is believed to be partially related to UV light exposure, genetics, and many other factors. Eventually, all of us will develop cataracts, but what about astigmatism?
Astigmatism prevalence is somewhere around 1 in 20 Americans. These patients have typically lived their lives with a certain degree of image distortion caused by the shape of the eye's lens. Cataract surgery with standard lens implants is designed to correct the cataract alone, but the TRULIGN™ Toric IOL will correct the cataract and astigmatism both at once with no change to the surgery itself.
If you have or are developing cataracts and have astigmatism, then the TRULIGN™ Toric IOL might be a great option for you to improve your vision beyond the standard IOL's ability after cataract surgery.
Lens implants are meant to last a lifetime. Fortunately, most people will be very happy with whatever lens implant choice they make. The CrystaLens, TECNIS, and ReSTOR lenses have all been rigorously tested by the US FDA before being approved for use. For most people, any of the three will provide excellent results. To arrange a consultation with one of our doctors to discuss specific recommendations for you, please contact us.
Our eye surgeons have a combined total of nearly 100 years of experience with nearly 50,000 lens implants of almost every type ever made. Harvard Eye Associates' surgeons were among the first in the world to use soft, folding lens implants for small incision cataract surgery in the 1980s and continue to break new ground being among the first surgeons in the country to be authorized to use the lenses described above.
Over the years we have conducted numerous clinical research studies on new implant technologies, and we continue to perform studies on existing and upcoming technologies. Our doctors have authored dozens of scientific publications, serve on scientific advisory boards for a number of healthcare technology companies, and are reviewers for major vision science journals.
*Individual results may vary considerably from patient to patient. Rare but significant surgical complications can occur with any lens implant. This document is intended only as a broad review of the general concepts involved in making a decision between lenses. It is beyond the scope or intent of this web page to provide an exhaustive review of lens implant technology or a prediction of what any individual patient may experience. Consult with your Harvard Eye doctor for more information.
As always, Harvard Eye is first and foremost concerned about what is best for each individual patient. Call us today for your personalized consultation!
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