|
LENSES SELECTION
OUTCOMES
|
A key goal of lens replacement is achieving the OUTCOME that matches the patient’s expectations. This means understanding the “big picture” of lens replacement well in advance of surgery. The result being that when it's time to select a lens, the patient will find it much easier to make an informed decision. The concepts can feel overwhelming which is why its important to have an experienced surgeon to navigate the process. Discussions should be collaborative and openly reveal any pros and cons without bias. This Shared Decison Making ensures that the patient feels heard and what they receive is what they expected.
|
||||||||||||||||||||
INSURANCE ONLY COVERS BASIC MONOFOCALS A large factor in the choice of lenses is the cost. Basic monofocals are typically fully covered with a goal of returning the patient to "useful vision". Useful means to drive legally, read signs, watch TV, and navigate daily life. This low bar is acceptable, but the highly-visual pace of life in the 21st century requires better results IMO. Unfortunately, the more expensive lenses such as EDOF, LAL, Torics, and Multifocals are not covered by insurance. While a profit motive can exist for any product or service this doesn't mean that these enhancements have no value. If I can get a better outcome I will gladly pay extra. Why accept mediocre vision for the rest of my life?
TOLERANCE FOR TRADE-OFFS Matched distance in both eyes has long been the goal of glasses and contacts. The trade-off is that a single-power lens can't focus across the entire span from near to infinity. This means whether you wear glasses/contacts or an IOL there will always be a finite range of focus: that's physics. As a workaround, Progressive and Bifocal glasses incorporate multiple powers into a single lens, while contact lenses and IOLs are available in multifocal versions. The point being that readers are still commonly needed to see up close. An alternate concept to understand is MONOVISION. In the 1960s clinicians noticed some people adapted well to one contact lens for distance and one for reading. In the 1970s the concept gained popularity when monovision-with-contact lenses was marketed to avoid wearing bifocal glasses. In the 1980s the concept was used to select IOLs for the same outcome. Monovision is not for everyone though. People who rely heavily on precise depth perception and 3D clarity for spatial judgment are said to be poor candidates. Their brains are used to extracting high-quality, matched images from both eyes—and don’t like giving that up. Because adapting to monovision can't be predicted, many surgeons will trial a patient with contact lenses to test monovision before surgery. After much thought I decided my desired Outcome was: driving glasses-free day and night — traveling, hiking and outdoor activities — watching live music events and cinema without anomalies or halos — and getting up in the morning and going to the kitchen with no glasses. I don't consider wearing readers a trade-off since most of the people I know over the age of 45 need them, even without IOLs. GLASSES ADAPT EASILY — IOLS DON'T. My next step was to schedule surgery.
| |
Datsunzgarage.us © 1997-2026
All comments are anecdotal only. This is not medical advice.
Datsun is a registered trademark of Nissan ®