About half of all Americans over 65 have some degree of clouding of the lens, and by 75 as many as 70% have cataracts that are significant enough to impair their vision. Dr Thomas LoPresti, who is a Doctor of Optometry, has considerable experience in advising older patients about cataract treatment. In this short article, he explains how not all cataract surgeries are equal - there are different options available to the patient, depending on the particular problem. Robert Griffith, Editor

Cataracts develop when the natural lens of our eyes become cloudy, affecting our sight. Visually significant cataracts can be easily removed and replaced with an intraocular lens implant (IOL) on an outpatient basis. Implants are similar to a small, soft contact lens, which contains your prescription. Patients now have two choices: standard or premium implants.

Standard Cataract Implants

Standard implants are designed to provide distance vision only. Reading glasses are then used for intermediate distances, such as using the computer and reading. Most older adults accept this very well, as they are accustomed to bifocals, progressive lenses, or reading glasses. Medicare and medical insurance companies typically cover standard implants.

Premium Cataract Implants

Premium implants are advanced-technology that provide distance vision, yet allow us to focus on near objects as well, reducing or eliminating the need for reading glasses. Premium implants are recommended for patients with healthy retinas, and should be implanted in both eyes. Premium implants are not covered by Medicare or medical insurance companies, and there is an additional out-of-pocket fee, ranging from $1,500 to $2,600 per eye, for these implants.

Types of Premium Implants

The Crystalens^® is the only true "accommodating" IOL. This design is a very thin, flexible implant with a hinged configuration, which mimics the eye's natural ability to focus on distance, intermediate, and near objects. Patents who receive this implant will also need to undergo a short period of vision training, or "eye exercises" to train the muscles in the eye to work with the new design.

The Restor^® IOL has a multifocal design that uses the principle of diffractive apodization to simultaneously focus the distance and near images. This implant works well on patients who are accustomed to wearing standard (lined) bifocals.

The Rezoom^® IOL is another multifocal design that is primarily a distance lens, but uses 5 annular refractive zones, distance alternating with near. The zones are blended, providing a progressive type effect, which is ideal for intermediate vision.

Conclusions

This is an exciting time in eye care, with many new technological advances that can significantly improve a patient's quality of life. If you are considering cataract surgery, be sure to discuss the options available with your ophthalmic surgeon or your co-managing optometrist.