All About Cataracts

The use of premium intraocular lenses (IOLs) in cataract surgery performed in the United States is increasing, according to recent surveys.

Premium IOLs include multifocal lens implants and accommodating IOLs. Both types of presbyopia-correcting intraocular lenses give patients a broader range of vision, reducing or eliminating the need for reading glasses after cataract surgery.

According to a recent survey of cataract and refractive surgeons reported by the eyecare industry research firm Market Scope, 71 percent of U.S. eye surgeons offered their patients the option of premium IOLs in 2008, up from approximately 59 percent in 2007. The company also estimates that 210,000 presbyopia-correcting IOLs were implanted during cataract surgery or other vision correction procedures in the U.S. in 2008, up from 153,000 in 2007.

Eye surgeons also say they prefer premium IOLs for the correction of high myopia. In a 2008 member survey of the American Society of Cataract and Refractive Surgery (ASCRS) more eye surgeons responding to the survey reported preferring premium IOLs (40 percent) to LASIK (23 percent) for the correction of large amounts of nearsightedness in patients desiring elective refractive surgery.

Among ASCRS surgeons using presbyopia-correcting premium IOLs, their top three lens choices in 2008 were the AcrySof ReSTOR multifocal IOL (Alcon), the Crystalens accommodating IOL (Bausch & Lomb) and the ReZoom Multifocal IOL (Abbott Medical Optics).

Other premium intraocular lenses include toric IOLs that correct astigmatism and aspheric IOLs designed to reduce glare and improve night vision.

Premium IOLs cost more than standard IOLs, and the added expense of these lenses typically is not covered by vision insurance and must be paid out-of-pocket, increasing your cataract surgery cost. However, most people who choose premium IOLs are very pleased with the added visual benefits the lenses provide, according to eye surgeons who offer them.

International eye care company Bausch & Lomb announced today the launch of a new consumer ad campaign for its Crystalens accommodating intraocular lens.

Ads will begin appearing today on national cable television markets in New York, Florida, Arizona and Las Vegas, Nevada. Ads will also appear in national magazines.

Crystalens is currently the only FDA-approved accommodating intraocular lens (IOL). It is designed to provide a full range of vision after cataract surgery, eliminating the loss of near vision and need for reading glasses caused by presbyopia.

“The advertising encourages patients to talk to their ophthalmologist about whether they are candidates for Crystalens or to visit the Crystalens website to learn more about this exciting vision correction alternative,” said Amy Jacobs, director of Global Marketing for Crystalens, in a press release issued by the company.

“Bad vision doesn’t have to be part of getting older. The Crystalens allows cataract patients the opportunity not just to fix their eyesight, but to make it better,” added Ms. Jacobs.

To learn more about Crystalens, visit the company’s website for the product or call 1-877-SEE-BETTER.

Crystalens HD, the latest generation accommodating IOL produced by Bausch & Lomb, improves vision at all distances compared to the company’s previous model, the Crystalens Five-O, according to a new study.

Speaking at the recent annual meeting of the American Society of Cataract and Refractive Surgery, Jay S. Pepose, MD, PhD, presented the results of a study of 67 eyes implanted with the Crystalens HD intraocular lens during cataract surgery. At one month after surgery, monocular testing of uncorrected visual acuity (UCVA) revealed:

• 79 percent of the eyes were 20/30 or better for distance vision
• 97 percent of the eyes were 20/30 or better for intermediate vision (approximately 32 inches)
• 85 percent of the eyes were 20/30 or better for near vision (approximately 16 inches)

Best-corrected visual acuity (BCVA) with eyeglasses for distance vision was 20/20 or better in 96 percent of eyes and 20/30 or better in 100 percent.

Compared with data from cataract surgery using the earlier Crystalens accommodating IOL, the new Crystalens HD provides better vision at all distances. Forty-two percent of eyes receiving the Crystalens HD IOL attained uncorrected distance vision of 20/20 or better, which is 50 percent higher than the percentage of eyes attaining the same level of UCVA after surgery with the Crystalens Five-O, said Dr. Pepose.

The Crystalens HD also surpassed the UCVA performance of a leading brand of multifocal IOL (AcrySof ReSTOR, Alcon) for distance and intermediate vision:

• 57 percent of eyes with Crystalens HD were 20/25 or better at distance
• 45 percent of eyes with the multifocal IOL were 20/25 or better at distance
• 91 percent of eyes with the Crystalens HD were 20/25 or better at intermediate
• 35 percent of eyes with the multifocal IOL were 20/25 or better at intermediate

The AcrySof ReSTOR multifocal IOL, on the other hand, performed better than the Crystalens HD accommodating IOL when comparing uncorrected near vision. Twice as many eyes receiving the multifocal lens attained 20/20 or better UCVA at near than eyes receiving the Crystalens HD. But the percentage of eyes attaining 20/30 or better UCVA at near was roughly the same for both groups (85 percent).

Accommodating IOLs are single vision intraocular lenses that move slightly in the eye in response to focusing effort to provide a full range of vision. Multifocal IOLs maintain a fixed position within the eye but have an optical portion that contains several lens powers to provide a full range of vision. Both types of IOLs can decrease the need for reading glasses and computer glasses after cataract surgery.

Accommodating IOLs and multifocal IOLs are premium intraocular lenses that cost more than traditional monofocal IOLs used in cataract surgery. Therefore, choosing these lenses will increase your cataract surgery cost. For details, consult a cataract surgeon near you.

Disclosure:  Dr. Pepose, director of Pepose Vision Institute (Chesterfield, MO) and professor of clinical ophthalmology, School of Medicine, Washington University (St. Louis, MO), is a paid a consultant to Bausch & Lomb.