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Modern Cataract Surgery-New Technologies and Costs

Cataract Surgery

(If necessary, familiarize yourself with cataracts by reading the related article on our website)

Cataract surgery is one of the most common surgeries performed around the world. It is one of a few unique procedures where dramatic changes for the better (clear vision and enhanced colour vision) are noticed in a short period of time after the surgery.

New technologies using laser systems and different types of lens implants are now available to provide better outcomes, reduce complications and provide different types of vision correction.

Laser Assisted Cataract Surgery

Laser instrumentation can now play a major role during cataract surgery. Several incisions are made within the eye tissues during the procedure. All of these incisions were traditionally done by a scalpel blade. Use of the laser allows for thinner and more consistent length and depth of incisions. The laser can also be used to break up the cataract much more efficiently and quickly compared to conventional ultrasonic means. Using the laser will help to speed up healing and reduce the risk of complications as the eye is less traumatized and not opened for any longer than necessary. Overall, laser assisted cataract surgery has been demonstrated to improve accuracy, safety and provide more predictable outcomes for vision and eye health.

Intraocular Lens Implants (IOL's)

The IOL is a man-made plastic implant that replaces the cataract within the eye. Lens material and vision designs have been the main technological advances help improve post cataract vision and eye health.

1. IOL Materials

Different types of plastic polymers have evolved over the years, the main advances coming in ultraviolet (UV) protection and softer materials. The softer material allows the implant to be foldable so smaller eye incisions can be made so the implant can be inserted into the eye and then unfold itself when final positioning is done within the eye.

2. IOL Vision Options

While the main priority in cataract surgery is to remove the cloudy lens of the eye, vision correction is usually incorporated into the IOL. There are now several options to correct distance and near vision.

1. Spherical Distance IOL

This is the basic type of IOL where the distance vision correction is incorporated for both eyes to target 20/20 vision for distance. Reading glasses would be necessary for computer and reading.


(Actual IOL Size)


2. Aspheric Distance IOL

An upgrade from the spherical IOL where the aspheric IOL surface is specially curved to reduce vision aberrations to provide clearer distance vision, similar to HDTV.

3. Astigmatism IOL

Patients who have a moderate to high amount of astigmatism would need this type of IOL to closer achieve 20/20 vision at distance.

4. Presbyopia IOL

There are various designs of presbyopia IOL's now available that attempt to achieve clear vision at all distances (far, intermediate and near) without having to use any glasses. Caution-while this technology is currently available, this type of IOL may not be suitable for all patients. Patient selection must be very specific to see if this IOL will meet each patient's own unique vision demands, i.e., golfing vs. sewing.

Another presbyopic IOL option is called monovision. In this case, a distance vision correcting IOL is placed in one eye and a near vision correcting IOL is placed in the other eye. Again, patient selection must be very specific as not every patient can adjust to having different vision between the two eyes.

Costs

When cataract surgery is approved, it is deemed to be 'medically necessary' and full cost is covered by the Alberta Health Care Insurance Plan (AHCIP). But included in this definition is coverage for standard operation procedures using a scalpel blade and distance vision IOL's.

Laser assisted cataract surgery and different IOL options above the standard IOL are not covered by AHCIP and the patient is responsible for these costs if they are chosen. There is variability in costs between the various IOL's as each performs a different function. There is also variability in laser and IOL costs between cataract surgeons. Since every cataract situation is different, we encourage patients to ask their Optometrist what options are best for them.