1. What is an advanced technology intraocular lens (IOL)?
The advanced technology IOL is a new, state-of-the-art type of intraocular lens that can provide a full range of vision, from near to distance, in most patients. The procedure for removing the natural lens and implanting the advanced technology IOL is the same that's been used for years in cataract surgery, but the result is a full range of vision, significantly reducing or eliminating the need for glasses or contact lenses.

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2. What makes advanced technology IOLs different from ordinary intraocular lenses?

Unlike an ordinary IOL, the advanced technology IOL can focus on objects near and far. The Crystalens® is designed to be focused by the eye's natural muscle; the ReSTOR® and ReZoom lens have special surface design that brings near and distant objects into focus without muscle assistance. All are intended to provide patients a fuller range of vision, reducing the need for corrective lenses. With ordinary IOLs, most people MUST rely on glasses or contact lenses for middle and near vision.

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3. Do advanced technology IOLs provide 20/20 vision for both reading and distance?

Advanced technology IOLs were created to provide a fuller range of vision, near to distance. Nearly everyone will find their uncorrected vision significantly better after surgery, but some will not see 20/20 through the full range of vision.

Pre-existing ocular and physiological factors may prevent full range 20/20 vision. Your doctor will advise you of any conditions which may affect the outcome of your individual surgery.

In a two-year FDA clinical study, 92 percent of participants with Crystalens® in both eyes achieved 20/25 or better distance vision, 96 percent achieved 20/20 at arm's length (middle vision), and 73 percent achieved 20/25 near vision without glasses or contact lenses.

To apply the study results to real life, 98 percent of participants were able to pass driver's license eye exam, read newspapers and phone books. All of them could read a computer screen, dashboard instruments, and supermarket price stickers; all the female participants could apply makeup.

In FDA clinical studies of ReSTOR^®, 80 percent of participants with the ReSTOR lens in both eyes did not use glasses or contact lenses after the procedure; 84 percent achieved 20/25 or better distance vision and 20/30 or better near vision and could read small stock quotes in a newspaper.

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4. How do advanced technology IOLs affect middle vision for tasks such as working on the computer? How does it compare to trifocals?

Advanced technology IOLs will greatly enhance middle vision, roughly arm's length, used for tasks such as using a computer, viewing dashboard instruments, or reading supermarket price stickers.

For many patients, there is no comparison to the hassle of trifocals. No matter the distance, near, middle, or far, your advanced technology IOLs can put your view in focus without the annoyance of tilting your head to see more clearly.

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5. How do advanced technology IOLs affect low-light vision?

Since the lens implant procedure replaces the cloudy natural lens with a crystal-clear IOL, the transmission of light to the retina should be enhanced. However, low-light vision is influenced by other factors, including the health of the eye in general and of the retina in particular. With time, it is normal for low-light vision to decrease. Adequate lighting is always beneficial, especially when reading.

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7. Will the doctor implant advanced technology IOLs in both eyes at the same time?

For the best result, advanced technology IOLs should be implanted in both eyes. Cataracts normally develop in both eyes at the same time. In the instance of only one clouded lens, only that lens needs to be replaced. For the typical patient, although both lenses need replacement, most surgeons prefer not to do them at the same time.

The normal procedure is to replace the lens that is most clouded first. The interval between surgeries depends on the healing of the first eye and the vision results; two to four weeks is typical.

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8. How long does the procedure last? Is it painful?

The actual implanting of the advanced technology IOL takes about 20 minutes; the whole visit to the surgical center usually takes less than two hours.

The patient arrives about an hour before the procedure and is given medication to induce relaxation and eye drops to anesthetize the eye and dilate the pupil.

During the procedure, the old lens is removed and the new lens implant inserted through a tiny incision. There is a sensation of pressure on the eye, but little or no pain.

After surgery, more eye drops are applied to prevent infection, and decrease inflammation. A protective patch is usually placed over the eye. Once home, the patient should rest and avoid any strenuous activities. The doctor will examine the eye the next day and advise the patient on the appropriate course of recovery, which will include continuing eye drops for a few weeks and avoiding strain on the eye until it is thoroughly healed.

Be sure to arrange for some one to drive you home after the procedure.

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9. What is the likelihood of complications, and what might they be?

Advanced technology IOLs are revolutionary, because, unlike ordinary IOLs, they provide multifocal vision. The standard cataract surgical procedure is performed on more than a million eyes each year, and has proven extremely safe; however, there is always a chance of complication with even the most routine surgery.

Most complications, such as minor infections, inflammation, and irritation, are temporary and easily treated. Serious sight-threatening complications, such as serious infection, hemorrhaging, or retinal detachment, are extremely rare. Complications are more likely in patients with diabetes and high blood pressure, and those who suffer from chronic inflammation and infections. About 98 percent of cataract surgery patients experience no complications and more than 95 percent achieve improved vision.

As with all surgical procedures, the eye doctor will perform a thorough examination and provide a complete evaluation of expected results and possible complications.

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11. Will lens implant surgery cause glare, night driving problems, and light sensitivity?

Glare, night driving problems, and light sensitivity can occur with both traditional and advanced technology lens implants. Night vision problems are usually much less severe than before cataract surgery. These phenomena are usually temporary and diminish as the brain and eyes adjust.

Light sensitivity is usually temporary. The crystal-clear material of the advanced technology IOL nearly always permits more light to pass through than the natural lens it replaces, so that some patients might have to adjust to seeing vivid colors and brighter lights than before surgery.

All intraocular lenses can produce glare, light flares, or a halo effect at night, since the pupil is open wider and allows light to reflect off the edge of the implant. Your doctor, through medication or night driving glasses, can usually compensate for these problems.

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12. How soon after lens implant surgery will I be able to resume normal activities?

Most patients require only a few days to resume normal activities, with some limitations and adjustments. Some sensitivity to touch and bright lights should not deter most patients from driving and returning to work.

Patients are given medications to prevent infection and control inflammation. A protective shield is advisable while sleeping, and sunglasses can provide protection during the day.

For several days after surgery, patients should avoid any heavy lifting or straining the can increase pressure in the eye. Rubbing or pushing of the eye and any situation that could result in being hit in the eye are also to be avoided.

Careful showering and shampooing are permitted, as long as no soap or shampoo touches the eye. Any makeup around the eye should be avoided for several weeks. Public swimming pools, hot tubs, and other potential sources of bacterial contamination should also be avoided.

When in doubt, the patient should consult the doctor for guidelines regarding post-surgical activities.

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13. Do the Multifocal lens require an adjustment period?

Yes. For most people there is a period of weeks when your brain is learning to "see" up close and at a distance with the new lens. This adjustment period is usually complete within 10 to 12 weeks. Also, like all multifocal lenses, some people report halos or glare around lights. Again, for most people this diminishes over time. For some, it becomes less troublesome but never completely goes away. Most people report that the ability to see near and far outweighs any visual side effects associated with the lens.

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14. How often do I need to have my eyes checked after surgery?

Your doctor will check your eyes the day after surgery, and, depending on your particular case, about one week, at four weeks, and again after about three to six months later. After that, annual eye exams are recommended, unless a specific problem develops.

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15. Can I go to any eye doctor for check-ups after the surgery?

The surgeon or a member of his or her team should perform the checkup on the day after surgery. The surgeon may approve subsequent checkups with another doctor, after a consultation with that doctor to ensure familiarity with your case and appropriate care.

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16. Will I have to have cataract surgery again?

In cataract surgery, natural lenses are removed and replaced with artificial lenses, which are not subject to deterioration and should last a lifetime.

Some patients experience subsequent clouding of the membrane which holds the lens, called the capsule. The normal treatment for this is a capsulotomy, in which a laser beam is used to create a hole through the membrane, allowing a clear path for light. It is a quick and painless procedure.

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17. What happens if my eye is injured some time in the future?

The presence of an advanced technology IOL does not make the eye more susceptible to damage from trauma. Most injuries affect the cornea, the clear front portion of the eye, or the retina, the light sensing lining on the rear of the eye. If anything, the lens implant eliminates the chance of cataract due to eye trauma.

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18. Does the presence of an advanced technology IOL rule out other eye surgery?

The advanced technology IOL takes the place of a natural lens in the capsular bag. Once healing is complete, usually about three months, other eye surgery will be unaffected by the presence of advanced technology IOL; it will be no different from surgery with a natural lens present.

Surgery on or around the eye should also be avoided until the implant procedure is well healed; this includes Botox^®, plastic surgery, or procedures performed on the surface of the eye. A doctor performing any procedure near the eye should be notified of a patient's eye surgery history.

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18. Does lens implantation have any effect on chronic red and irritated eyes or headaches from eyestrain?

Red, irritated eyes and eyestrain are often caused by inappropriately wearing contact lenses and or dry eye syndrome. Implantation of advanced technology IOLs may help the situation, if it reduces or eliminates the need for contact lenses.

These symptoms can be caused by several other factors, including allergies; consulting a doctor is recommended.

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19. Will security eye scanning still work after advanced technology lens implantation?
Security scanners usually read patterns on the iris or retina, and should not be affected by the presence of an advanced technology IOL or standard IOL.

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20. Is advanced technology IOL implantation covered by insurance?
Most private insurance covers the cataract surgical procedure and the anesthesia, but may cover only a portion of the cost of an advanced technology IOL, since it costs more and is considered non-standard.

Patients should consult with both the doctor and the insurance carrier to determine their best alternatives.

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21. How can I be sure an advanced technology IOL implant surgeon is qualified?

Most advanced technology IOL surgeons have been thoroughly trained, and have experience in performing standared cataract surgery, applying the same techniques used to implant the advanced technology IOL.

Starting the search for an implant surgeon on the internet can save a lot of time and travel, but, once the field has been narrowed, a face-to-face consultation with the surgeons is best to facilitate meaningful dialogue. Asking questions and building a good rapport with your surgeon is always beneficial and more comforting.

Direct contact with patients who have had advanced technology IOL implant surgery is also very informative.

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