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3-D Eye Online - Cataract Surgery - Lens Options: Accommodative

Accommodative Lenses

These newer IOL types reduce the need for glasses or contact lenses.

  • The design of the accommodative lens allows certain eye muscles to move the IOL forward and backward, changing the focus much as it would with a natural lens, allowing near and distance vision.
  • The ability to read and perform other tasks without glasses varies from person to person but is generally best when multifocal or accommodative IOLs are placed in both eyes.
  • It usually takes 6 to 12 weeks after surgery on the second eye for the brain to adapt and vision improvement to be complete with either of these IOL types.

Surgeons at the Kearney Eye Institute offer the Crystalens accommodative IOL that, unlike a standard IOL, can treat both a person's cataracts and presbyopia—loss of near and intermediate vision. You probably noticed in your forties that you started to lose some of your up-close vision and had to start wearing reading glasses. Crystalens not only treats your cataracts; many patients hardly if ever wear glasses after surgery. It does so by recreating accommodation similar to your eye's natural lens. The unique Crystalens is designed to allow you to enjoy a fuller, more natural range of vision for most activities, including: reading a book, working on the computer, and driving a car.

Crystalens was modeled after the human eye. Like the natural lens, it is a lens implant that uses the eye muscle to flex and accommodate in order to focus on objects in the environment at all distances. Crystalens dynamically adjusts to your visual needs.

Crystalens is designed to allow the optic, or the central circular part of the lens that you see through, to move back and forth as you constantly change focus on images around you. Crystalens, like your natural lens, flexes as you focus your vision.

Crystalens is:

  • The first and only FDA-approved accommodating intraocular lens
  • The only FDA-approved intraocular lens that uses the natural focusing ability of the eye
  • The only FDA-approved presbyopia correcting IOL for cataract patients that provides a single focal point throughout a continuous range of vision

Few patients with Crystalens have experienced problems with glare, halos and night vision. Crystalens focuses only one image to the back of the eye, unlike a multifocal lens that projects multiple images, requiring your brain to "adjust" to the differences.

The effectiveness of Crystalens was proven in clinical trials:

  • Significantly more patients implanted with a Crystalens (88.4%) could see better at all distances than patients implanted with a standard IOL (35.9%).
  • Most patients have continued to report excellent vision 7 years after implantation with Crystalens. More than 200,000 Crystalens intraocular lens implants have been implanted worldwide, and that number is growing daily.

Crystalens accommodates like the natural lens. After implantation of Crystalens, most patients will see brighter and clearer across a wider range of distances like they did when they were younger.

ONLY FDA-Approved accommodating IOL
Crystalens was the first presbyopia correcting IOL introduced into the United States market and is currently the only FDA-approved accommodating IOL. Crystalens addresses the limitations of standard monofocal IOLs and multifocal IOLs by providing the following advantages to patients:

  • Provides a Broad Range of Vision: Crystalens moves and changes shape using the eye's natural focusing mechanism, instead of remaining fixed and stationary within the eye. This movement, or accommodation, allows the eye to focus on objects across a broad range of distances. Many patients hardly if ever wear glasses after surgery. In particular, this accommodation provides significant advantages in addressing intermediate vision.
  • Maintains Clarity of Vision: Unlike multifocal lenses, Crystalens directs all available light received by the eye to a single focal point, comparable to that of a healthy natural lens.
  • Patient Adjustment Not Required: Crystalens produces a single image consistent with normal vision, meaning patients do not need to neuroadapt to viewing multiple images. Patients also do not need to tolerate or adjust to high levels of halos and glare often associated with multifocal IOLs.

Following surgery, optimal results will not be immediately apparent. You might not see your full visual outcome for one to three months. Most find that their vision continues to improve with time.

A 12 point font shown here should be a reasonable expectation for uncorrected near vision in the majority of patients.

+1.00 and +1.50 readers may be needed to see fine print, read a book, or perform complex near vision tasks.

For certain levels of astigmatism, it may be necessary to have another procedure to treat this condition following or during surgery.

Sometimes an enhancement is needed to fine tune your surgery. An enhancement is usually not advised until 3 months after your initial surgery

Considerations with Accommodative IOLs
For many people, these IOL types reduce but do not eliminate the need for glasses or contact lenses. For example, a person can read without glasses, but the words appear less clear than with glasses.

Each person's success with these IOLs may depend on the size of his/her pupils and other eye health factors. People with astigmatism can ask their eye surgeon about toric IOLs and related treatments.

Side effects such as glare or halos around lights, or decreased sharpness of vision (contrast sensitivity) may occur, especially at night or in dim light. Most people adapt to and are not bothered by these effects, but those who frequently drive at night or need to focus on close-up work may be more satisfied with monofocal IOLs.

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3-D Eye Online - Cataract Surgery - Lens Options: Toric

Toric IOL for Astigmatism
This is a monofocal IOL with astigmatism correction built into the lens.

  • Astigmatism: This eye condition distorts or blurs the ability to see both near and distant objects. With astigmatism the cornea (the clear front window of the eye) is not round and smooth (like a basketball), but instead is curved like a football. People with significant degrees of astigmatism are usually most satisfied with toric IOLs.
  • People who want to reduce the need for eyeglasses may opt for an additional treatment called limbal relaxing incisions, which may be done at the same time as cataract surgery or separately. These small incisions allow the cornea's shape to be rounder or more symmetrical.


Protective IOL Filters
IOLs include filters to protect the eye's retina from exposure to UV and other potentially damaging light radiation. The eye surgeon selects the filters that will provide appropriate protection for the patient's specific needs.

Other Important Cataract Lens Replacement Considerations
In some cases, after healing completely from the cataract lens surgery, some people may need further correction to achieve the best vision possible. Their ophthalmologist may recommend additional surgery to exchange an IOL for another type, implant an additional IOL, or make limbal relaxing incisions in the cornea. Other laser refractive surgery may be recommended in some cases.

People who have had refractive surgery such as LASIK need to be carefully evaluated before getting IOLs because the ability to calculate the correct IOL prescription may be affected by the previous refractive surgery.

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3-D Eye Online - Cataract Surgery - Lens Options: IOL Overview