About Cataracts and Refractive Lens Exchange

Cataract is an opacification of the normally crystal-clear lens inside the eye, which causes decreased vision.  This is a bilateral condition (affects both eyes), although it is common for one eye to be somewhat worse.  The natural lens sits behind the iris (color of the eye) and is responsible for 1/3 of the eye’s focusing power.

cataracts-vs-clearlens-02The lens can also change shape as you attempt to focus up close, allowing for near vision.  The ability to see up close slowly diminishes beginning in the mid-forties – a term called presbyopia. In addition, as we age, or after being chronically exposed to certain chemicals (steroids and other medications), the lens loses its clarity and starts yellowing.  Everyone who lives long enough will eventually get cataracts, which are the leading cause of reversible blindness in the world.

The earliest symptoms of cataracts include: a change in a patient’s glasses prescription; decreased comfort when driving at night; glare, halos, and starburst patterns when looking at lights; and blurred reading vision, especially in dim light (contrast sensitivity loss).  With time, these changes worsen, making it increasingly difficult to read in any but the brightest lighting conditions.  People often give up driving at night, stop reading as frequently as they would like, and have difficulties discerning colors.

Cataract surgery replaces the worn out natural lens with a clear intraocular lens implant (IOL).  This outpatient procedure takes about 10 minutes to perform per eye, requires only eye drops for anesthesia, and has a relatively quick recovery time.

At SightTrust Eye Institute, we offer the option of having both eyes operated on the same day, or having one eye operated on at a time. The IOL is measured to correct your individual prescription needs.

cataracts-vs-clearlens-01Depending on the type of IOL you choose, cataract surgery can improve both your distance and near vision, often providing freedom from driving and reading glasses!

Individuals who do not have cataracts that are significantly interfering with their vision, but do suffer from presbyopia, nearsightedness and/or farsightedness, can take advantage of a procedure that is identical to cataract surgery.  Refractive lens exchange, or clear lens extraction, are both terms that describe replacing the natural lens with an IOL that can improve both distance and near vision. As with cataract surgery, the choice of implant is based on the health of your eye as well as your visual requirements.

Clear lens extraction (CLE) is ideal for patients in their 50s and beyond, or for those younger individuals who need to wear reading glasses full-time. The natural lens – which no longer can focus for reading – is replaced with an implant that permanently restores near vision. The implant can improve distance, intermediate, and near reading.

Once the IOL is in place, the vision it provides you does not change over time.  Additionally, the material does not cloud up over one’s lifetime.  So once you have a cataract or refractive lens exchange procedure, you will never develop cataracts again or require another lens surgery!

PanOptix® Trifocal and Trifocal Toric

AcrySof®IQ PanOptix® Trifocal Intraocular Lens (IOL) is the first and only trifocal lens for patients undergoing cataract or lens replacement surgery. PanOptix is clinically shown to deliver an exceptional combination of near, intermediate and distance vision while significantly reducing the need for glasses after surgery.

The PanOptix® Trifocal IOL is a multifocal IOL that focuses images clearly onto the back of your eye (retina) to allow clear distance vision after cataract or clear lens removal. In addition, the center of the PanOptix® lens allows for better near (reading) vision and intermediate (computer work) vision compared to  a monofocal (single focus) lens.

ReSTOR® Multifocal Toric

Patients with astigmatism may also enjoy true performance at all distances with the AcrySof® IQ ReSTOR® Multifocal Toric IOL. This lens combines the benefits of a full range of vision provided by the ReSTOR® IOL with the astigmatic correction of the  Toric IOL.

The ReSTOR® Multifocal Toric IOL treats both presbyopia and astigmatism in one surgery.

ReSTOR® Multifocal

The ReSTOR Multifocal implant provides excellent vision over a wide range of distances, reducing or eliminating your need for glasses for the majority of activities such as:

Driving, reading, using your smart phone, laptop, desktop, or tablet computers, playing cards, watching TV, golfing, and more!


Crystalens® uses the eye’s internal muscles to flex in order to focus on objects at varying distances, from distance to intermediate tasks. It is designed to allow you to enjoy a wide range of vision for most activities, including:

Reading, working on the computer, and driving.

TECNIS® Multifocal

The TECNIS® Family of IOLs provides a wide range of vision for distance and near tasks. Each lens is optimized for peak performance at one of three strategic distances based on varying visual demands.

AcrySof® Toric

AcrySof® Toric is a terrific option to reduce astigmatism while at the same time providing excellent distance or near vision.  It can even be used to provide one eye with distance vision while the other eye is focused for near tasks, a treatment called monovision.

AcrySof® Monofocal

For those individuals who prefer excellent distance or near vision only, the AcrySof® Monofocal provides crisp, quality vision.  The implant can also be used for monovision, allowing one eye to see up close while the other is focused for distance.