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Presbyopia Correcting Intraocular Implants

IOLs are soft, foldable lenses that are inserted into the eye in order to replace the natural lens that developed the cataract. These lenses are also viable options for some patients who have not yet developed cataract but want to reduce or eliminate their need for glasses with a procedure known as refractive lens exchange or RLE.

Cataract surgery and Refractive Lens Exchange are identical procedures. The only difference is that with RLE, the lens is still mostly clear. Made of plastic or silicone materials, IOLs come with monofocal, multifocal, or extended depth of focus.

Monofocal IOLs provide a single zone of clear focus and are usually implanted to provide excellent distance vision. Patients with monofocal IOLs will typically require the use of reading glasses for near vision tasks, such as reading or sewing. Multifocal, extended depth of focus and accommodating IOLs (Advanced IOLs) are designed to provide a fuller range of vision with minimal, if any, need for glasses or contact lenses.

Friends Laughing while eating breakfast at a restaurant

At Slade & Baker Vision we specialize in implantation of the most popular Premium Technology IOLs such as the Panoptix Trifocal, Vivity Extended Depth of Focus, and the RxSight Light Adjustable Lens.

*To show the level of precision possible when adjusting this lens, the engineers made this video of adjusting the lens shape to reflect the Slade & Baker Vision logo.  It is time-lapsed and magnified.

We are also proud to share that we now offer the RxSight Light Adjustable Lens. It has the highest accuracy in the post-operative vision of any IOL ever used and we are one of the few sites nationwide who offer this lens.  Please feel free to call our office at 713-626-5544 to learn more about the RxSight Light Adjustable Lens and schedule an evaluation to determine if it is the right lens for you.

Premium IOLs

If you are nearing the age for cataract surgery and want a reliable vision correction solution, premium lens implants might be a good idea. These lens implants are also referred to as “lifestyle lens implants” because afford excellent vision sometimes without the need for glasses. Before choosing that these premium lens implants are right for you it is important to discuss your lens implant options with your cataract surgeon.

As previously mentioned, several years ago patients only had the option of monofocal lens implants, which enabled vision at one distance only. Now, these new implants can offer a wide spectrum of vision including near, intermediate, and far vision. Premium lens implants have been helping people over 40 and cataract aged patients since they became a viable option. Could you possibly imagine being able to read the newspaper, drive at night, or play golf without the use of eyeglasses?


Modern-day lens implants for after cataract surgery have been significantly improved over the last ten to twenty years. Prior to the advent of premium lens implants or multifocal IOLs, a cataract surgery patient had one option. This one option was a monofocal lens implant, which could only correct vision at one distance.

Now, patients have the options for multifocal and accommodating lens implants that can correct vision at near, far and intermediate distances. Some patients that receive this lens implant can even eliminate glasses from their lifestyle. These intraocular lenses come in a variety of materials and designs. Your cataract surgeon will be able to advise you on what type of lens would be best for your unique visual situation. It is important for patients to realize that while cataract surgery with intraocular lens implantation frequently results in a reduced dependency on eyeglasses it is never guaranteed to eliminate this need totally.

Multifocal IOLs

A multifocal iol

Intraocular lenses (IOL) are implantable lenses that are inserted into the eye during cataract surgery. These lenses are made of plastic or silicone materials and placed permanently in the eye after removal of the eye’s natural lens. Intraocular lenses may be either monofocal or multifocal. Monofocal lenses have a single zone of clear focus, usually set for excellent distance vision, but require the use of reading glasses for near tasks, like reading or sewing. Multifocal lenses have several zones of clear vision and allow for both distance and near vision correction.

Basically stated, a Multifocal IOL is a unique lens that provides patients with quality vision including near, far, and intermediate distances. Many patients who have had this lens implant option do not need to rely on their glasses or bifocals after cataract surgery.

Multifocal IOL’s reduce the likelihood that you will be required to wear glasses or contacts after surgery. Multifocal lenses incorporate both distance and near powered lenses into one lens. The lower power zones bend the light coming from distant objects to a single focal point on the retina. The higher power zones bend light from near objects to the same focal point on the retina. Thus, different zones of lens power work together to provide the eye with near and distance vision.

Multifocal IOL lens implants enable patients to see near, far, and intermediate distances after surgery. With a multifocal IOL, the central portion of the lens has a series of steps that are carved in a very precise arrangement with varying step heights and distances between steps. Each of the steps of this diffractive optic bends the incoming light differently; creating a near focus that is quite separated from the distance focus formed by the remaining refractive portion of the lens.

This large separation between the two images allows for fewer artifacts or distortion in either of the images, providing good quality of vision at both distance and near. There are several different brands of Multifocal IOL Lens implants, and at Slade & Baker Vision Center, our surgeons will determine along with you, which implant is best for YOUR vision and your visual goals.

Life after cataract surgery used to always require glasses since lenses only gave patients good distance vision. Now, new options for better vision after cataract surgery have been created.  As we age our eyes lose their ability to change focus and adjust from viewing something far away, like driving, to something up close, like reading a newspaper. This ability to focus on is called accommodation.

We are so fortunate now that advances in IOL implants have given cataract surgery patients more options after surgery!  There are many different brands and choices of Multifocal lenses out there, and here, at Slade & Baker Vision Center, your surgeon will determine along with you, which lens implant is best suited for YOUR vision and your visual goals!

Is a Multifocal IOL Right for Me?

If you are a cataract patient who will have to rely on reading glasses or bifocals after your cataract surgery you may be a candidate for a Multifocal IOL. It is important that you speak with Dr. Slade to determine your vision expectations after cataract surgery. Although insurance generally covers monofocal lens implants, it does not cover multifocal lenses.


Monofocal IOLs

Monofocal lens implants work when light enters the actual lens and it is bent to a specific focal point. As the power of the monofocal lens becomes stronger, its ability to bend light more sharply is increased. Because the lens is monofocal, the light can only be bent to one focus point at a time. The light from these lenses is bent to focus specifically on the retina of the eye.

New lens implants are now available that can correct vision at near, intermediate and far distances. These types of lenses are commonly called “lifestyle lens implants” or premium lens implants and fall into the categories listed below. Multifocal, toric, and accommodating lens implants are all considered premium lens implants.

Astigmatic Premium Lens Implants

Treating Your Astigmatism

You may have astigmatism and not even know it. Even people who have never worn glasses or contacts can have astigmatism in the cornea that only becomes visually apparent after the natural lens or cataract is removed. It can occur along with nearsightedness and farsightedness and, if present, will blur your vision at all distances.

Types of Astigmatism

There are two main types of astigmatism- corneal and lenticular. Corneal astigmatism is present when the cornea, or outer window of the eye, is more curved in one direction than the other, similar to the shape of a football. Small amounts of corneal astigmatism can be neutralized or minimized by the shape of the natural lens inside the eye, which is why some people have astigmatism and never knew it.

After cataract surgery with astigmatism treated (left) versus after cataract surgery with untreated astigmatism (right).

After cataract surgery with astigmatism treated (left) versus after cataract surgery with untreated astigmatism (right).

With lenticular astigmatism, the lens inside the eye can also be curved and can balance corneal astigmatism. When the lens is removed, however, patients with corneal astigmatism will experience blurry vision that will require glasses unless they have their cornea treated for astigmatism during their cataract procedure.

At Slade & Baker Vision we use our femtosecond laser to treat small amounts of astigmatism at the time of surgery. For patients with more significant astigmatism, we use one of the Advanced Toric IOLs that have built-in astigmatism correction below. As with everything at Slade & Baker Vision, the surgical plan is totally customized.

Vivity® Lens

The Vivity® IOL gives patients distance and intermediate vision with a reduced optical side effect payoff.  If a patient has had dryness, previous eye surgery, early macular degeneration, early glaucoma, or other eye diseases which would make their eyes “not healthy enough” for a trifocal range-of-vision lens, the Vivity® may be a good option. Before the Vivity® lens, most patients with “less than perfectly healthy eyes” would otherwise have to settle for a basic monofocal lens with no range, and they would typically have to deal with a separate pair of computer (intermediate) glasses and reading (near) glasses.

Toric IOL – AcrySof® Toric

Toric IOL

If you are seeking a Houston cataract surgery expert and have astigmatism please feel free to consult the doctors at Slade & Baker Vision Center. There are NEW options available for patients that have astigmatism and need an IOL for after cataract removal.

The AcrySof® Toric IOLs are artificial lenses that are ideal for individuals who have cataracts and also suffer from astigmatism. This lens is manufactured by Alcon Technologies a widely known and respected producer of intraocular implants. Please feel free to review images of the lens and watch a video related to the procedure and the patients who have tried this lens.

You may be familiar with the term TORIC if you have ever used astigmatic correcting contact lenses. Toric Lens Implants are a unique type of lens implant that is used to correct astigmatism.

A toric lens implant is NOT the only method of astigmatism correction so consult a doctor about the current possibilities. The asymmetric steepening of the cornea or natural lens causes light to be focused unevenly, which is the main optical problem in astigmatism. To individuals with uncorrected astigmatism, images may look blurry or shadowed.

Astigmatism can accompany any form of refractive error and is very common. Astigmatism can be corrected with glasses, contact lenses, corneal relaxing incisions, laser vision correction, and special implant lenses.

If a cataract patient has astigmatism and has aspirations to be glasses-free after surgery a Toric lens implant is a good option. Toric lens implants are NOT a correction option for presbyopia. The ACRYSOF® Toric lens implant is a popular choice for this type of lens.

Astigmatism is caused by an irregularly shaped cornea, or in the case of lenticular astigmatism, an irregularly shaped lens, that results in blurred vision. Since the Toric IOL is convex on both sides, it allows for the correction of both these types of astigmatism.

Before the Toric IOL, cataract patients with astigmatism would often undergo another procedure, called astigmatic keratotomy (AK), which involved creating incisions in the cornea to adjust the corneal shape.

The doctors at Slade & Baker Vision Center understand how frustrating it can be to live with astigmatism and we hope we can offer a viable solution in a premium lens implant that is used during the cataract surgery procedure.

Lens technologies are constantly changing in the world of ophthalmology so we encourage you to continuously check with us about options for you and your loved ones. Patients should consult a qualified ophthalmologist like Dr. Slade to determine which lens would be right for them and if a refractive lens exchange would be advisable as well. If you are experiencing presbyopia or cataracts, please feel free to consult us about the possibility of utilizing this accommodative intraocular lens or any of our other premium lens options at Slade & Baker Vision.

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The doctors at Slade and Baker Vision have either authored or reviewed and approved this content.

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Houston, TX 77027

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