Standard IOL: These implant lenses are fully covered by medical insurance, but do not address astigmatism or presbyopia. They are safe and optically excellent, but generally patients will likely need glasses for all three distances (distance, intermediate and near) to get the best vision.
Standard Toric IOL: These implant lenses have an astigmatism correction built into the lens, so when placed in the eye and aligned with the patient’s pre-existing astigmatism, can allow for quite good vision at one distance (distance, intermediate or near). It is more than likely that glasses may be required for better vision at other distances. There are additional fees for toric lenses.
Crystalens and Trulign IOL: These implant lenses are the only FDA approved accommodating intraocular implant lenses. The Trulign is the toric version (fixes larger amounts of astigmatism) of the Crystalens; they both work the same way. These lenses are able to move a little bit inside the eye, allowing patients to have a bigger range of vision without glasses compared to standard or standard toric lenses. They are not, however, good enough to go all the way from perfect distance to perfect reading vision, but are generally quite good at giving two out of three distances without glasses. As a result, after both eyes are done, we are generally able to get quite good distance and intermediate vision, and 50% of patients do not need reading glasses. These lenses are also less prone than most standard lenses to optical aberrations including edge glare and night time optical aberrations. There are additional fees for the Trulign and Crystalens, and those additional fees include a LASIK or PRK touch up within the first year if the target of good distance vision is not achieved. It is impossible to achieve excellent distance vision in all cases because of the biology of human variation, so missing the intended target is possible with all types of implant lenses, and can be fixed with glasses, contact lenses, or laser vision correction with LASIK or PRK.
Vivity and Vivity Toric IOL: These are FDA approved extended depth of focus implant lenses. These lenses, much like the Trulign and Crystalens, can reduce astigmatism and increase the range of vision without glasses, but are also not good enough to go all the way from perfect distance to perfect reading. In comparison to the Trulign and Crystalens, because the optics of the Vivity are not dependent upon movement of the lens (which is less predictable), the range of vision is more predictable, and only 35% of patients still need reading glasses. There are additional fees for the Vivity lenses, and that additional fee also includes a LASIK or PRK touch up if the distance target is not achieved acceptably.
Symfony and Symfony Toric IOL: These are also FDA approved extended depth of focus implant lenses. These lenses, much like the Vivity lenses, can reduce astigmatism and increase the range of vision without glasses, but are also not good enough to go all the way from perfect distance to perfect reading. In comparison to the Vivity the range of vision is a bit more predictable, and only 25% of patients still need reading glasses. The tradeoff for less dependence on reading glasses with the Symfony lens is that 15% of patients have a spider web visual effect around lights at night. There are additional fees for the Symfony lenses, and that additional fee also includes a LASIK or PRK touch up if the distance target is not achieved acceptably.
PanOptix/ other Multifocal IOL: These lenses actually have multiple lens powers built into the lens, so most patients (over 90%) do not need intermediate or reading glasses. These are not good lenses if you have other medical ocular problems such as macular degeneration, or other retinal problems or certain corneal problems. The other issue with these lenses is that 30% of people have halos or rings around lights at night. These lenses also have an additional fee that also includes a LASIK or PRK touch up if the distance target is not acceptably achieved.
