Refractive Surgery Options: Multifocal, Accommodating and Toric IOLs
Eric D. Donnenfeld, MD, FAAO
Multifocal, accommodating and toric IOLs (intraocular lens implants) are manmade lenses used to improve vision following cataract surgery or refractive lens exchange (RLE). Multifocal lenses are designed with multiple "rings" that allow the eye to focus on objects at multiple distances, including near, intermediate and far. Accommodating lenses also allow the eye to focus at various distances, but they do so by moving within the eye rather than providing different focusing zones. Toric IOLs are designed for the treatment of astigmatism.
Please read the paragraphs below to learn about the different types of multifocal, accommodating and toric IOLs.
AcrySof ReSTOR IOL
AcrySof ReSTOR was approved by the FDA in 2005 for improvement of postoperative cataract vision with or without presbyopia. The ReSTOR IOL contains concentric rings that create different zones that bend light as it enters the eye to provide clear vision at multiple viewing distances. Postoperative cataract surgery patients who receive the ReSTOR lens are therefore often able to see clearly at various distances, often reducing their dependence on corrective eyewear. AcrySof ReSTOR provides excellent near and distance vision and good intermediate vision.
Tecnis Multifocal IOL
Tecnis Multifocal, the most recently developed IOL, received FDA approval in early 2009. Similar to the ReSTOR lens, Tecnis contains several concentric rings that create different zones that allow the eye to focus at various distances. However, unlike the ReSTOR lens, the rings in Tecnis are located at the back of the lens and continue outward with an increasing distance between the rings. Tecnis Multifocal provides good near, intermediate and distance vision and can be used to correct the vision of patients who have small pupils.
The Crystalens IOL is the only FDA-approved accommodating IOL. It is designed to correct near vision due to presbyopia without compromising intermediate and distance vision. Unlike multifocal lenses, which contain focusing zones, Crystalens works by moving in response to the eye's muscles, thereby improving its ability to accommodate (shift its focus from one distance to another). Patients who receive Crystalens are able to achieve excellent near and intermediate vision. However, those who also have poor distance vision and/or astigmatism may require corrective eyewear.
AcrySof Toric IOL
The AcrySof Toric IOL differs from multifocal and accommodating IOLs in that it was specifically designed to correct astigmatism. The unique design of the toric IOL allows patients to experience improved distance vision after cataract surgery or RLE. Individuals who receive toric IOLs may still need to use corrective eyewear for near vision but have excellent distance vision.
Dr. Donnenfeld is a highly regarded eye surgeon who has successfully used IOLs to correct the vision of many of his patients throughout the Tri-State area. He is among the most experienced IOLs surgeons in the United States and has been instrumental in the development of these state-of-the-art lenses as an FDA investigator.