I have choices between a fixed lens covered by inusrance A multi focal distance for $1100 And a lens for 20/20, no glasses needed for $3,000. Any advice? Thank you!
To get better comments you should post the brand and model of the lenses you are considering. When you said “multi focal distance for $1100” did you really mean “monofocal” for distance? In the no glasses needed option there are many choices, all quite different, and all with their pros and cons. The devil is in the detail.
When you say MF do you mean a bi-focal. A bi-focal should provide distance and close. I have the Tecnis MF +2.75 in my left eye. In general bi-focal has fallen out of favor for the tri-focal.
I am surprised there is a $2K difference in one premium lens over another, so I am a bit confused.
You need state what specific IOLs you are looking at.
Thank you, I will try to find out
Here is some information I got from the internet and modified it a bit to cover the two more popular brands in the US - J&J Tecnis and Alcon AcrySof.
Understanding the various lens options for cataract surgery is essential before making your lens choice during the preoperative visit. Your overall eye health (dry eyes, corneal irregularity, previous LASIK, or macular degeneration), prescription, and the amount of corneal astigmatism that you have will play a big part in determining which lenses will give you the best results.
The primary decision is the type of vision you want to have after surgery:
Good Distance Vision – but wear reading glasses
Good Reading Vision – but wear distance glasses
Good Distance Vision plus Computer Vision
Good Distance, Computer, and Reading Vision
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Monovision – distance vision in one eye and reading vision in the other eye. I only recommend this option in patients that have done this previously with contact lenses, since many patients cannot tolerate monovision. Monovision limits depth perception, which can diminish balance and increase the risk of falling.
The main types of intraocular lenses are:
Single Vision (Tecnis Monofocal ZCB00 or AcrySof IQ Aspheric Monofocal) It can be calculated to be used for either distance vision OR reading vision. If you choose distance vision, you need to wear glasses for reading. If you prefer reading vision, you need to wear glasses for distance. This lens does not correct for astigmatism, so if you have corneal astigmatism, you will likely see better wearing bifocal or progressive glasses to correct for this condition. Single Vision is the only type of lens covered by Medicare and insurance, so there is no extra out-of-pocket expense for this lens.
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Toric (Tecnis Toric or AcrySof Toric) — similar to the single vision lens, but corrects for astigmatism. This allows patients with astigmatism to see well in the distance OR near, and then wear glasses for the other one. Insurance, Medicare, and secondary insurances do not cover this lens, so there is an out-of-pocket expense.
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Extended Vision (Tecnis Symfony, AcrySof Vivity or toric versions of these) — this lens offers a continuous range from distance to mid-range. Halos are less common than traditional multifocal lenses, and patients often use reading glasses for fine print or extended reading. There is an out-of-pocket expense for this lens. Vivity may be more free of halos than the Symfony, but also not as good for reading smaller print.
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Trifocal (Alcon Panoptix, Panoptix Toric) — gives good distance, computer, and reading vision. Some patients may see halos or starbursts in certain light conditions. There is an out-of-pocket expense for this lens.
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There are other versions of these lenses, but these are some of the more common options. The most common choice made for a lens is the monofocal single vision option for distance, and the use of reading glasses. It is the least expensive, and most certain of quality vision. Other options for a wider range of vision are more expensive and can have some undesirable side effects. They are mainly used by those who really want to be eyeglasses free, and are prepared to accept the side effects.
Wow, thank you for all of the helpful information. I postponed the evalulation and same day surgery because I was not informed of my options and the the MF lenses have to be ordered. So my two choices are mono (free) or multi $3,200.) Multi includes Symphoni, Panoptixs (which from what I gather is superior to Symphini and now Vivity.
I used to have 20/20, then became far sighted, needing reading glasses, which I got off the rack. I was ALWAYS losing them so I had about 25 pairs.
Then everything switched and I could see books and computers but not far. So I got bifocals for that, and only wore them to drive.
Then all of the sudden everything far is blurry and I need to see to drive and read street addresses. Not to mention the other issues of feeling driving blind in sun or rain.
Difficult choice. Readers are a pain and would be expensive to replace when I lose them. But if I got the close up lens, then I guess I would have to wear trifocals all the time to see far and between close and far???
You only mentioned Panoptix and Symfony. Are you in the US? If so what state.
There are other FDA approved and hopefully soon to be FDA approved lens.
So if you are not desperate you might want to wait on some of the new IOLs to become available.
My best recommendation is find an Ophthalmologist that has implanted MANY Premium IOLs and give you a complete history of what he has experienced with the lens.
“And a lens for 20/20, no glasses needed for $3,000.”
That Statement is scarry to me. If your Opthamologist said those exact words I would RUN!!!
All IOLs current available come with a issues and you better be aware of those issues. There is no free lunch with IOLs and everyone results will vary.
Least Risky to Most Risky IMHO
- Standard Monofocal,
- LAL - I would choice this option if getting a Monofocal,
- Refractive EDOF IOLs - Vivity and Enyhance - Gives better intermediate vision than a standard monofocal, but my guess it comes at the cost of better contrast,
- Defractive IOLs - Symfony Plus, Tecnis Synergy and PanOptics. Each has their pluses and minus, but they come with dysphotopsias.
I was just watching a video on Vimeo that someone else recommended on the Synergy. I think it is a bit of a fluff piece sponered by JNJ, but did show a night time simulation of halos and glare.So it is at least worth watching and if that amount of dysphotopsias bothers you do not get a defractive lens as that video IMHO is about as good a result as one can get.
Try searching “Breakthrough innovation with a new presbyopia-correcting IOL” and you should be able to find it.
what is a LAL? I’ve never heard of that.
just reading about it. I’ve never heard of that and don’t think I’ve ever seen it on this forum as an option
Light Adjustable Lens.The problem is doctor many times do not hit the refractive mark and sometimes can be 1D or more off. LAL allows the doctor to change your prescription after surgery.
Here are a few videos on you tube you can search for on this IOL. These are top Clinical Trial Doctors. I think Soks has gone to Vance Thompson Vision.
“Vance Thompson Vision KELOLAND Living - Light Adjustable Lens for Cataract Surgery”
“David Chang, ESCRS 2019 - Light adjustable IOLs”
“Dr. John Hovanesian- The RxSight™ Light Adjustable Lens for Cataract Surgery”
I guess most people doing web researching on IOL are not looking for monofocal options, but looking for an option to get an extended range of vision.
But what is bothersome is your Opthamologist does not even mention it.
A co-worker was telling me about his Monofocal and vision issues and I asked did he think about a premium lens and he said he never heard of them and his doctor did not mention it to him. On his next appt. he asked the doctor about them and the doctor just said they had to many issues and did not implant them.
The doctor did not even seem to realize there are newer refractive IOL options. Just SAD IMHO.
I wonder how available the LAL lens is. The theory is good, but many surgeons may not venture into that world, or have the equipment to do it. I think one of the factors in successful cataract surgery is the experience of the surgeon in using the specific lens. If they are not implanting the lens many times a day, they may not be good at it!
Please please realize that all lens are not perfect and there are disadvantages to anything you choose. Also if your doctor is GUARANTEEing 2020 vision, run away. There is no way anyone can guarantee that after lens replacement
i dont think lal is fda approved so not available in US. only benefits i see for lal are to eliminate refractive surprises and for monovision where you should be able to strike the right difference in diopters between the two eyes to optimize near vision. however i do not know if u can go up and down the diopters before u lock an lal.
LAL was FDA approved back in 2017 and available. I know there Opthmalogist in my area that implanted them, but maybe they require extra equipment, which only a few doctors have.
My guess is the trials were done at the Codet Vision Institute in Mexico as they were the leaders on this IOL.
From the FDA site:
“FDA approves first implanted lens that can be adjusted after cataract surgery to improve vision without eyeglasses in some patients”
If you are allowed to do multiple vision updates this lens would be perfect for trying various monovision powers and seeing you outcome.
if you go to RSsight you can search for a doctor in your area.
i didnt know it was fda approved. vance thomson is the only physician in my state doing it.
I am new to the cataract business as you seem to be also. All the different lens choices are hard for me to figure out, but in doing my research I did find one particular article to be helpful in understanding more about the lens choices.
I don’t think we can post direct links so do a google search for:
sciencedirect(.)com/science/article/pii/S016142020308435 and check it out. You need to remove the parentheses around the period, then you could copy and paste into a browser.
Good luck with your choices. I have my first consultation next Wednesday, and look forward to seeing what the surgeon recommends!
bricks, I tried that info in my browser and could not find the article. It may help if you give the title, author, and date of the article. This site is a major pain in that it does not allow the inclusion of actual links.
RonAKA, I tried it and it didn’t work for me either.
Here is the title of article and author:
“Matching the patient to the intraocular lens: Preoperative considerations to optimize surgical outcomes” by Elizabeth Yeu, M.D. published 08/30/2020 i believe.
Hope that helps!
OK, yes I have that article saved. It does cover a lot of the issues with IOLs but I found it a bit difficult to read. It is basically a summary of the findings of many different studies, and at times uses very technical terminology.