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Common Questions about Presbyopia-correcting IOLs

If you need cataract surgery, you may have the option of paying extra for new presbyopia-correcting IOLs that potentially can restore a full range of vision without eyeglasses.

Presbyopia-correcting IOLs are a relatively new option, so you may have questions such as:

1. What are presbyopia-correcting IOLs?

Presbyopia-correcting intraocular lenses (IOLs) are lens implants that can correct both distance and near vision, giving you greater freedom from glasses after cataract surgery than standard IOLs. They are available in two forms: multifocal lenses and accommodating lenses. Multifocal lenses are similar to multifocal contact lenses - they contain more than one lens power for different viewing distances. Accommodating IOLs have just one lens power, but the lens is mounted on flexible "legs" that allow the lens to move forward or backward within your eye in response to focusing effort to enable you to see clearly at a range of distances.

2. Aren't presbyopia-correcting IOLs a lot more expensive? How much extra do I have to pay?

Yes, presbyopia-correcting IOLs are more expensive than standard IOLs. Costs vary, depending on the lens used, but you can expect to pay up to $2,500 extra per eye. This added amount is usually not covered by Medicare or other health insurance policies, so it would be an "out-of-pocket" expense if you choose this advanced type of IOL for your cataract surgery.

3. Why won't Medicare or health insurance cover the full cost of presbyopia-correcting IOLs?

A multifocal or accommodating IOL is not considered medically necessary. In other words, Medicare or your insurance will pay only the cost of a basic IOL and accompanying cataract surgery. Use of a more expensive, presbyopia-correcting lens is considered an elective refractive procedure, a type of luxury, just as LASIK and PRK are refractive procedures that also typically are not covered by health insurance.

4. Can my local cataract surgeon perform presbyopia-correcting surgery?

Not all cataract surgeons use presbyopia-correcting IOLs for cataract surgery. Make sure your eye surgeon has experience with these lenses if you choose a multifocal or accommodating IOL. Studies have shown that surgeon experience is a key factor in successful outcomes, particularly in terms of whether you will need to wear eyeglasses following cataract surgery.

5. Are any problems associated with presbyopia-correcting IOLs?

At a 2007 American Society of Cataract and Refractive Surgery conference, some reports indicated that even experienced cataract surgeons needed to perform enhancements for 13% to 15% of cases involving use of presbyopia-correcting IOLs. Enhancements don't mean that the procedure itself was a failure, because you likely will see just fine with eyeglasses even if your outcome is less than optimal. But it's possible you may need an additional surgical procedure (such as LASIK) to perfect your uncorrected vision after cataract surgery with a presbyopia-correcting IOL. Depending on the arrangement you make with your eye surgeon, you also may need to pay extra for any needed enhancements.

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