Premium Lens Implants offer a new alternative for cataract patients seeking a broader range of vision than the vision provided by traditional “mono-focal” lens implants. Recent technological breakthroughs have led to the development of several exciting new options for cataract patients, including the Tecnis, Tecnis Symfony and ReSTOR premium lens implants which can provide a broader range of vision, greatly reduce dependence on glasses and correct for presbyopia. The Tecnis and ReSTOR lenses are called “accommodating” or “multifocal” intraocular lenses because they allow the eye to accommodate a greater range of vision (from near to far vision) than the traditional “mono-focal” implant, which typically can only correct for distance vision. In addition, the Tecnis Symfony lens provides an extended depth of focus vision and the Acrysof Toric lens implant can help reduce or eliminate astigmatism after cataract surgery. NY Vision Group is pleased to offer these alternatives to our patients in New York City and Queens.
Multifocal Lenses – ReSTOR, Tecnis
The AcrySof ReSTOR lens is a premium implant that can restore a range of vision with increased independence from glasses or contact lenses. For most patients, the ReSTOR IOL delivers excellent near and far vision and good intermediate vision without reading glasses or bifocals. In fact with this increase in vision quality, ReSTOR patients would be able to pass the visual acuity part of the driver’s license exam in most states (without glasses!). The AcrySof ReSTOR lens is a unique technological innovation which is particularly well suited for patients who would like to have a chance of eliminating glasses. The ReSTOR lens has been FDA-approved for cataracts, with or without presbyopia since March 2005 and was approved for use in Europe two years prior to that time.
How Does ReSTOR Work?
ReSTOR Lens New York
As we perform daily activities such as reading, watching television or working on the computer, our eyes are constantly changing focus through a process known as “accommodation”. This task is performed by the lens of the eye, which changes shape, or accommodates, to allow the eye to focus at different distances. As we age, however, our lens loses the ability to change shape and thus our accommodating ability diminishes, causing us to become more dependent on bifocals or reading glasses. The Acrysof ReSTOR IOL is a foldable IOL lens that was designed to overcome this dependence, helping correct for the condition known as presbyopia. It features the latest of apodized and refractive technologies similarly used in microscopes and telescopes to improve image quality.
During ReSTOR’s clinical studies, patients experienced lifestyle enhancement through quality vision and greater freedom from reading glasses and bifocals. In fact, according to these clinical studies, four out of five patients who received ReSTOR lenses in both eyes reported never wearing glasses following their surgery, compared to only 1 out of 10 patients who received standard monofocal lenses. This is the highest level of freedom from glasses ever demonstrated in an IOL clinical trial.
In addition, clinical studies showed that:
- Nearly 94 percent of patients in the clinical study were so satisfied with their vision they would have the AcrySof® ReSTOR® lens implanted again if given the choice.
- 84 percent of patients demonstrated uncorrected vision without glasses of 20/25 or better for distance. (This is significant since in most states 20/40 vision is required to pass the vision test for a driver’s license without glasses or contact lenses.)
- 84.3 percent of patients with the AcrySof® ReSTOR® lens in both eyes achieved distance visual acuity of 20/25 or better in both eyes following surgery and near vision acuity of 20/32 without reading glasses or bifocals.
Typically there is an adjustment period for ReSTOR and all multifocal implant lenses, as a patient’s brain learns to see up close and at a distance. Also, as with all multifocal lenses, some patients report halos or glare around lights after their surgery. However, only 5% of patients receiving the ReSTOR implant had noticeable nighttime halos, and most of those reported decreased symptoms over time. Most patients reported that their ability to see near, intermediate and far distances outweighed any visual side effects.
The AcrSof ReSTOR lens comes from Alcon, a world leader for cataract surgery. It is made of the same material as Alcon’s widely-used AcrySof intraocular lens, of which more than 25 million have been implanted worldwide.
The TECNIS IOL is a multifocal IOL designed to give patients an increased range of vision. The TECNIS is the most recent innovation in lens implant technology and is the first IOL with a patented wave-front designed optic for recreating more youthful vision. It is specifically designed to provide safer, sharper vision at any distance and any light condition.
Peak vision usually occurs at age 19, when a person has zero spherical aberrations (i.e. zero distortions in vision) and when contrast sensitivity and quality of vision peak. As we age, however, the eye’s spherical aberration (distortion) increases, reducing functional vision. Spherical aberration causes diffusion of light resulting in blurred vision, reduced contrast sensitivity and decreased function. The TECNIS IOL addresses this problem as it is designed to reduce spherical aberration. In fact, a clinical study showed that the average ocular spherical aberration of TECNHIS IOL eyes was not significantly different than zero, i.e. approximately the youthful vision of a 19-year old.
How Does the TECNIS Lens Work?
The Tecnis Multifocal lens replaces the natural lens and is implanted into the eye during cataract surgery. It has a patented optic design that works like a bifocal lens inside the eye. For long-distance vision, the Tecnis multifocal lens creates a clear image of the far-away object while at the same time a second, a highly defocused image is created for near vision that is typically not perceived. For near vision, the Tecnis multifocal lens creates a clear, sharply focused near the image and a second highly defocused far away image that is typically not perceived. This unique multifocal optic design gives it the ability to provide clear vision near, far and in-between without mechanical movement of the lens. Because the Tecnis multifocal lens does not work with the muscles of the eye, it is not dependent on a mechanical process or the movement of the lens to give clear vision.
The Tecnis Multifocal lens is similar to two lenses in one. One, a refractive lens is for distance, the other, a lens for near vision. This gives the Tecnis multifocal IOL more consistent results and more satisfied patients who can enjoy activities like reading, sewing, seeing their smartphone or looking at the fine print on documents, all without the hassle of reading glasses, bifocals, progressive lenses or contact lenses.
Who is a Candidate?
Virtually everyone who has cataracts and/or presbyopia (loss of ability to refocus near vision, noticed after age 45) and is in good general health may be a candidate for refractive lens exchange and/or cataract surgery with the ReSTOR, Tecnis multifocal, or Tecnis Symfony implant. If a patient has significant astigmatism, they may be a candidate for a TORIC lens implant.
Anyone who has a normal eye exam and is dependent on reading glasses or bifocals may be a candidate. Although Tecnis multifocal lenses are a breakthrough technology initially approved for cataract patients with or without presbyopia, it is not necessary to need cataract surgery to qualify for the Tecnis multifocal lens, just a desire to reduce or eliminate your dependence on glasses. Also, individuals with more extreme levels of nearsightedness or farsightedness may be better candidates for lens replacement surgery with the Tecnis multifocal lens than laser vision correction. After a thorough examination, we will be able to better advise you if you qualify for the Tecnis multifocal implant.
The Tecnis multifocal IOL has been shown in a clinical study to provide good near, intermediate and distance vision with increased independence from glasses in patients who have undergone cataract surgery. Patients with the Tecnis multifocal lens in both eyes have a 90% chance of not needing glasses for any activity. Results from a controlled clinical study of the Tecnis multifocal IOL revealed that maximum visual performance is achieved when the lens is implanted in both eyes. Benefits are apparent with individuals in whom the lens is used in only one eye as well.
Clinical data demonstrates that the Tecnis multifocal IOL greatly reduces dependence on glasses or bifocals:
- Over 94% of patients said they would choose the Tecnis multifocal lens again.
- Nearly 9 out of 10 patients enjoy freedom from glasses after receiving the Tecnis multifocal lens.
Furthermore, the TECNIS can provide significant improvement in functional vision, including potentially improving driving vision. In studies submitted to the FDA, the TECNIS lens improved the identification distance for a pedestrian hazard by 14 meters compared to a traditional spherical lens implant (resulting in an additional half-second to perceive and react to a driving hazard).
Nonetheless, everyone’s focusing ability is different. Most people will be able to see clearly in the distance, have a very good reading vision and functional intermediate vision without glasses, but some people may be more comfortable with additional correction, particularly for long periods of computer work. After surgery with the Tecnis multifocal lens, it may be necessary for some people to wear glasses for distance, intermediate and/or near vision to obtain optimal visual acuity. The difference from basic lenses is that most people will not be as dependent on these supplemental vision aids to function normally.
What are the Risks?
Lens replacement surgery is identical to cataract surgery and results in safe and successful outcomes in approximately 98% of eyes treated. Like any surgical procedure, there are risks. During your visit to NY Vision Group the risks, benefits and surgical alternatives will be discussed with you. Fortunately, cataract surgery is one of the most common and safest surgical procedures performed in the U.S. today with 3 million procedures performed annually.
Some visual effects associated with multifocal IOLs may be expected because of the superposition of focused and unfocused images. These may include a perception of halos/glare around lights under nighttime conditions. It is expected that, in a small percentage of patients, the observation of such phenomena will be annoying and may be perceived as a hindrance, particularly in low illumination conditions. On rare occasions, these visual effects may be significant enough that the patient will request the removal of the multifocal IOL. Additionally, individuals who are planning on receiving a multifocal lens may need an additional procedure to “fine-tune” their vision.
Extended Depth of Focus – Tecnis Symfony
The Tecnis Symfony is the first and only Extended Depth of Focus (EDOF) Presbyopia-Correcting IOL that provides continuous, high-quality vision at any distance. It is intended to provide high-quality vision from near to far and points in between and may reduce the frequency of wearing glasses. The Tecnis Symfony was approved by the FDA for cataract use in 2016.
How Does Tecnis Symfony Work?
Tecnis Symfony New York
The Tecnis Symfony is the first lens of its kind to combine two unique technologies for outstanding visual performance: 1) elongating the focus of the eye to provide continuous, high-quality vision; and 2) correcting chromatic aberration (color distortion) to provide sharp vision in all lighting conditions.
With Tecnis Symfony patients may be able to comfortably enjoy low-light activities such as taking a walk at dusk, going to the movies or even driving at night. Some patients do experience a loss of sharpness, which may become worse under poor visibility conditions such as dim light or fog. In addition, as with any surgical procedures, inherent risks exist with all multifocal implants, whether the Symfony or ReSTOR, and a patient’s results cannot be guaranteed.
FDA Clinical Trial Information (based on a randomized clinical trial)
- 77% of patients receiving Tecnis Symfony implants had good vision(20/25) without glasses at an intermediate distance, compared to 34% of patients who received standard monofocal implants
- For near distances, patients with the Tecnis Symfony lens were able to read two more progressively smaller lines on a standard eye chart vs. patients receiving monofocal implants.
- Both sets of patients had comparable results of good distance vision.
- At the six month visit, 85% of the Symfony patients reported wearing glasses a little or none of the time in the week prior to their visit.
What are the Risks?
Lens replacement surgery with accommodative lenses is similar to cataract surgery and results in safe and successful outcomes in approximately 98% of eyes treated. Like any surgical procedure, there are risks. During your visit to NY Vision Group the risks, benefits and surgical alternatives will be discussed with you.
Please contact our New York office if you are interested in the Tecnis Symfony or other multifocal implants.
The Acrysof Toric lens implant differs from the multifocal implants describe above in that it was specifically designed for patients who have a significant amount of astigmatism. In the past, when patients with significant astigmatism had cataract surgery, they would still require glasses for near and distance vision (because of their astigmatism). The design of the Acrysof Toric lens makes it possible to reduce or eliminate astigmatism and improve uncorrected distance vision. As with the other premium multifocal implants described above, there is an additional cost for this lens implant. However, we strive to make all of these lenses affordable through our various payment options.