New IOLs may eliminate need for eyeglasses and contact lenses

For most people, the need to wear eyeglasses to read is an inevitable part of aging. The eye’s natural lens hardens and loses its ability to change shape, making it more difficult to focus, especially when reading up close.

With age also comes the development of cataracts or clouding of the eye’s natural lens. Intraocular lenses (IOLs) traditionally have been used to replace the eye’s natural lens after its removal during cataract surgery. However, with the traditional IOLs, most patients still needed to wear glasses for reading and using the computer. This, however, may be changing.

The FDA recently approved the Crystalens, the first of a new generation of IOLs that, in many cases, can allow people to see without eyeglasses or contact lenses. American Academy of Ophthalmology spokesperson Neil F. Martin, M.D., F.A.C.S., of Chevy Chase, Md., “Unlike older fixed-focus IOLs that do not move, the Crystalens is able to move and can focus like a younger eye’s natural lens.” The Crystalens use hinges, which are attached to the eye’s muscles. This allows the lens to move, or accommodate, so you can focus on objects near, far and all distances in-between seamlessly.

What about Crystalens for people who haven’t yet developed cataracts? Although FDA-approved for cataract patients, the Crystalens is a physician-discretionary alternative to LASIK for boomer-aged patients contemplating vision correction. Patients with astigmatism may have relaxing incisions at the time of Crystalens implantation or they may have LASIK afterwards. Patients considering this form of vision correction should consult an eye surgeon who is an expert in Crystalens implantation and LASIK to determine the best option.

Dr. Martin, who is clinical assistant professor of ophthalmology at the Georgetown University School of Medicine-Washington National Eye Center combined Departments of Ophthalmology said, “The ideal candidates for Crystalens IOLs are about 50 or older. The candidate should have healthy eyes, other than perhaps having cataracts. Patients who have previously had cataract surgery or significant eye disease, such as glaucoma, macular degeneration or diabetic retinal disease are not good candidates for this procedure.”

“The procedure costs about $5,000 per eye. For people with cataracts, insurance usually covers half the cost. Financing and cafeteria-plan accounts may make the Crystalens procedure more affordable,” Dr. Martin said. Unfortunately, Medicare currently does not cover Crystalens IOLs for patients with cataracts or allow for cataract patients to pay for upgrades themselves.

There are other accommodating IOLs that are currently awaiting FDA approval. Dr. Martin does expect the FDA to formally approve the IOLs for people who don’t have cataracts, but wish to have their refractive errors corrected.