What Are IOLs?              

For many years, surgeons have used intraocular lenses (IOLs) during cataract surgery for vision correction after the removal of the eye's old lens.  IOLs are 5 or 6 mm lenses that are usually made of silicone or plastic inserted into the eye.  Lenses come in foldable and non-foldable varieties, the later of which can be slipped into the eye through small incisions, and unfold once inside.           

Recently non-cataract patients have been able to achieve improved vision with the advent and FDA approval of (some) phakic IOLs, which are placed into the eye without the removal of the eye's original lens.  This type is typically used in patients with severe near or farsightedness, and sometimes in presbyopia sufferers, patients of middle age or older who are dependant on reading glasses.   

How It's Done

During cataract surgery the cloudy or discolored eye lens is removed, and replaced with an IOL, while phakic IOLs are placed directly over the existing lens.  In either case, the surgeon can make either a long incision along the side of the eye in which a non-foldable IOL can be placed, or a smaller incision for the foldable type, although the later is the more common practice. 

The procedure can be as short as fifteen minutes and is usually done as an outpatient surgery with the aid of a local anesthetic administered in the form of eye drops. 

Technology

The earliest and most common form of IOLs for cataract surgery is monofocal, designed to correct vision at one distance.  In 1998 the FDA approved the Array multifocal lens, the first of its kind, which provides patients with reduced dependence on glasses.  IOLs are now made from a wide variety of different materials and can correct any vision problem of varying severities.

Recovery/Post op Expectations  

Directly after surgery, protective eyewear is required and you will need a friend or family member to drive you home.  Irritation and discomfort is normal, but should disappear within a few days.  Eye drops are often prescribed to remedy these problems.  Everyday activities can be returned to within a few days, although heavy lifting and other strenuous activities should be avoided.  

Vision returns to normal within eight weeks in most cases, as the surgically repaired eye takes time to focus with the other.  Vision is usually blurry for the first several days and light often appears brighter through the new, clear lens.  Because there are several different IOLs made of different material, correcting an array of refractive problems, individual correction will vary.  In general, however, 90% of patients enjoy dramatically improved vision following surgery.

Complications          

The most common side effects include redness, irritation, bleeding, and infection, all of which usually can be treated quickly with medication or eye drops.  Other serious, though rare, complications include loss of eyesight, thinning of corneal tissue, iris inflammation, and the development of cataracts.

Am I A Candidate?              

A candidate for IOL insertion after cataract surgery is someone who has developed a cataract that is impairing vision, and has no medical conditions that disallow the use of an IOL.  Many phakic IOLs are still experimental and seeking FDA approval.  Because of this, they are normally recommended for patients with refractive problems that are uncorrectable with other procedures such as LASIK.  

Cost              

Costs of cataract surgery vary based on severity, type of removal procedure, and lens replacement.  On average, however, phaco surgery with an IOL replacement is about $1,128 and extracapsular removal with an IOL is around $906 with a monofocal IOL.  Cataract surgery is covered by most healthcare providers.             

Phakic IOLs can range from $1,500 to $3,000 depending on the lens used.  This type of procedure is considered cosmetic, and is, therefore, not covered by health insurance.