As you use the focusing muscles inside your eye, the Crystalens flexes to change shape and position to focus on closer objects. A small amount of flex of the intraocular lens would bring intermediate objects, like the computer into focus while a greater amount of flex would bring near vision into focus This ability to focus makes the Crystalens an accommodating intraocular lens.
The FDA has approved a toric version of the Crystalens called the Trulign Crystalens that will both accommodate to give focus but also has astigmatism correction built in to give even clearer vision. Trulign toric accommodating intraocular lenses are used for patients with significant astigmatism. At your preoperative visit your ophthalmologist will measure the amount of astigmatism in your cornea and let you know if the Trulign Crystalens in right for you.
This lens implant does not split the light into multiple images like a multifocal lens so it tends to provide better contrast for distance images. If this lens flexes freely in your eyes, then it is the best intraocular lens in the world. What varies from one person to the next is how much it flexes. Some can make it focus from distance to near and everywhere in between. In my experience, most patients (90%) get distance and intermediate vision without glasses and about half get distance, intermediate, AND near. Around 10% of patients can’t flex the lens so they have distance vision and use glasses for intermediate and near vision. The question is how accommodating is your accommodating intraocular lens (that was supposed to be a joke.)
Recently, a friend of mine stopped by the office to discuss cataract surgery. She was having enough trouble with her vision that we decided to fix her cataracts. She valued high quality distance vision and spends a lot of time on the computer. She was fine using readers for up close vision if she needed them, but hoped to see the computer without glasses.
After discussing her goals, we decided that the Crystalens was the best choice since we had a 90% change of giving her both distance and intermediate with the accommodating lens implant. She happened to get distance, intermediate, AND reading vision, so we exceeded her expectations.
If you desire good distance quality, want intermediate vision without glasses, and would be fine with using readers if necessary then the Crystalens may be the ideal choice for you.
The greatest risk of any intraocular lens is that we aim for perfect but you end up a bit near or far sighted which could require and adjustment. I have had one patient that had me exchange the implant for a different style of lens because of edge glare out of the hundreds that I have implanted so this is very rare. I have had a handful that I have adjusted in the office with a laser because scaring had tilted the lens implant. This complication is called a Z syndrome. This complication has largely disappeared with the newer models of the Crystalens.
The lens implant is made of a very durable silicone that has blocks uv up to 350 nm range. This means the lens implant will protect your retinas from most, but not all of the suns harmful uv rays. It is recommended that you wear sunglasses after surgery for prolonged sun exposure.
The Crystalens accommodating intraocular lens costs extra as it is considered an advanced technology IOL. Standard intraocular lenses are covered by and provided by your insurance company. Advanced technology IOL’s require that you pay some amount extra to pay for the additional expenses and testing to go into a lens that provides extra benefits to your lifestyle like the Crystalens. If we are doing image guided laser cataract surgery with a Crystalens accommodating intraocular lens we charge around $3,000.00 more to cover the extra service and expenses involved per eye. You would not pay these additional Crystalens costs if you had non-image guided, non laser, non advanced IOL cataract surgery.
A number of IOLs have become FDA approved that compete with the strengths of the CrystaLens. The most popularly chosen of those competitors are the Vivity Lens and the PanOptix lenses. Your eye doctor will visit with you to help recommend the best intraocular lens for you. If I can help, please schedule a time to visit with me.