Cataract Accommodating Lens -- Lowering Patient Expectations
What is a Cataract Accommodating Lens?
A Cataract Accommodating Lens is an artificial lens that is used to replace the eye’s natural lens when a cataract surgery is preformed.
IOL’s (intraocular lenses) have been around for decades. What is new is the concept of an Accommodating Lens. By “Accommodating” the lens either shifts, bends or otherwise changes to allow the patient to see at all distances. It should be noted that with the current accommodating lenses, the need to where glasses is NOT always eliminated. If one reads carefully (hard to do with cataracts!) one will find terms like “most patients” and “often patients… will no longer need glasses to read or do computer work.”
Why no statistics?
There are currently 2 opposing forces at play when it comes to accommodating lenses. One side, the device maker side, is looking to raise patient expectations. This is simple capitalism at work. They have shareholders, and this is what companies do.
On the opposing side, there are the physicians and surgeons who find themselves on the frontline. They, in their own words need to “Manage Patient Expectations.”
For surgeons, properly managing patient expectations can make or break the outcome of the surgery. Unlike the device makers, surgeons are tasked with facing the patient when they are unhappy with the results (i.e. they still need glasses to read). It is therefore clear why surgeons are beginning to attempt to manage patient expectations. Another way to put it would be to say the surgeons are cutting through the device maker hype and informing their patients that there is a chance that despite paying thousands of dollars (out of pocket, as most insurance plans do not cover accommodating lenses) that they will still require glasses to read.
Is Effective Near Enough?
"A third type of presbyopia-correcting IOL, the Crystalens (eyeonics), is the first IOL approved in the United States that mimics the accommodation or movement of the natural lens, as described by Helmholtz." ... "The irony is that, while this lens provides good distance and intermediate vision, the near vision is limited. Patients aren’t getting a full a range of vision, as they do with the pseudo-accommodative IOLs."
"...in our clinical experience, patients are achieving J5 to J6 reading vision, which really is not good enough for spectacle independence at near. In addition, patients need to do some rehabilitative exercises over several months to years to get what full near vision effect it is capable of." Marc Bloomenstein, O.D
Review of Optometry
Currently there is only one FDA approved Accommodating Lens. There are however many more in the pipeline. Soon, patients will have a real choice to make. Another Accommodating Lens is expected mid 2009 with more to follow it. In the near future the device maker that most clearly informs patients (in the form of advertising) will most likely be the victor in this exciting race to eliminate the need for glasses. Currently, they aren’t there yet!
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