A Doctor’s View: Presbyopia Correcting Intraocular Lenses
By Dan Siapco MD
The landscape of presbyopia correcting intraocular lenses, or PCIOL’s, has changed considerably in the last 3-5 years. There are now more very practical lenses that can help to minimize or entirely eliminate the need for glasses after cataract surgery.
This has not always been the case. I started implanting PCIOL’s in 2003 right after I graduated from residency. At that time there were very few options a surgeon could choose from. There was much left to be desired with the early PCIOL’s. Glare symptoms and compromised night driving vision were commonly seen, as well as reading distances that were not always very convenient. I gravitated towards the ReSTOR PCIOL by Alcon which boasted good reading vision. The first iteration of the ReSTOR PCIOL required patients to hold objects much closer than normal. Their intermediate vision (computer distance) was also suboptimal and frustrated some patients. Because of this, I had to address astigmatism with special corneal incisions and at times use LASIK surgery.
As time passed, new and improved versions of the ReSTOR PCIOL came on the market and allowed me to provide acceptable intermediate vision as well as astigmatism correction for patients. Other companies tried to introduce PCIOL’s (such as the Crystalens and Symfony), but because of inherent challenges with each of these technologies, these PCIOL’s did not stay competitive and faded away.
The two newest PCIOL’s that I have found to be my go-to lenses are the PanOptix and the Vivity, both manufactured by Alcon. Unlike their predecessors, these PCIOL’s deliver good near, intermediate, and distance vision and have very low levels of glare noted by patients at night while driving. The Vivity has also allowed me to implant PCIOL’s in patients that were previously not candidates for PCIOL technology. These patients include those who have had LASIK, retinal disease, moderate to severe dry eyes, and glaucoma, among others.
I am excited about the future of presbyopia correcting intraocular lenses and the inevitable improvements we will see as time passes. Talk to your doctor to see if you are a candidate for any of these exciting technologies at your cataract surgery consultation.
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