• In good health with an active lifestyle, and hoping to reduce or eliminate the need for glasses. • Patients who have hyperopia prescriptions – these patients tend to have the very best outcomes with multi focal IOLs because of better focusing ability. They appreciate the near vision improvement they are likely to have. • Patients who have high or severe myopia prescriptions – these patients have been so used to extremely blurry vision without glasses that the improvement they gain with a multifocal IOL, even with some visual distortion, is dramatic and greatly appreciated. Poor candidates for multifocal IOL generally are: • Patients who have had near perfect vision without glasses, prior to cataract surgery. These patients have enjoyed such great vision all their lives that the minor nuances and imperfections in the multifocal IOL are generally unacceptable to them. • Extreme perfectionists. Neuro-adaptation is very difficult for these patients. • Patients with ocular disease other than cataract. Retinal or corneal disease generally reduces or eliminates the appreciation a patient would have with a multifocal IOL. • Patients who drive at night for a living, or whose hobbies or activities depend on good night vision. Preferred candidates for the toric IOL should have: • A vision-compromising cataract • Pre-existing astigmatism • An interest in reducing the need to wear glasses for distance As long as the eye is healthy enough to achieve the good outcome that the patient is expecting and has the necessary degree of astigmatism, there is little downside to placing the toric implant. However, these IOLs are meant to treat regular astigmatism, not irregular astigmatism as is found in patients with a history of radial keratotomy (RK), corneal transplant, or keratoconus. A thorough examination and diagnostic testing will be performed to confirm candidacy for the toric IOL. Most patients are candidates for the basic IOL. There are extremely rare occasions when an IOL is not placed in the eye, but generally all patients who undergo cataract surgery receive an intraocular lens implant. Will I need additional procedures to achieve the best result? Much like contacts or glasses, IOLs come in more than 60 different “powers”. As with a glasses or contact lens prescription, it is important to match the appropriate IOL power to your eye. When prescribing glasses or contacts, we use trial and error to preview different lens powers to determine which one you see best with. However, because an IOL is implanted inside the eye, and only after your natural lens has been removed, it is impossible for you to “preview” various IOL powers before surgery. Furthermore, once it is implanted it cannot be easily exchanged as glasses or contact lenses could. Fortunately, an appropriate IOL power can be estimated using advanced mathematical formulas based on the measurements of your eye’s dimensions. Although these formulas are quite accurate in most patients, there are individual variables that prevent this process from being 100%
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perfect. In particular, individuals who are extremely nearsighted, farsighted, or have high amounts of astigmatism, and patients who have had previous refractive surgery (RK, PRK, Lasik) are more likely to end up with an IOL power that is not optimal because the mathematical formulas are based on average sized eyes, not extremes or eyes that have had previous surgery. IOLs are high performance devices and require precisely tuned optics. If the IOL power is not optimal, the IOL will not perform as well as desired. In these situations, a patient may discover the vision is adequate for most tasks and that wearing a very thin pair of glasses helps them out in certain situations (e.g. night driving). Alternatively, an additional procedure, such as Lasik or PRK, can be performed to optimize the outcome. There is a 15-20% chance that a secondary procedure like Lasik will be necessary to fine tune the vision. Is there anything I can do to help improve my outcome? Yes. Follow all preoperative instructions, especially instructions regarding contact lens wear. Generally, we ask that you discontinue wearing any contact lenses for a period of time before your surgical measurements as the shape of your eye can change. Even a small change in the shape of your eye can change the IOL calculation dramatically. Also, occasionally it is necessary to ask you to return for repeat measurements, or to return for additional testing in order to get the best calculation or determine your candidacy for a particular IOL. Are there any payment options available if I’m interested in the multifocal or toric IOL? Yes, we would be happy to discuss them with you.