New lens implant for cataracts is a bionic-style bifocal

For most of us, wearing eyeglasses is an inevitable part of getting older. But for some patients, reaching for a pair of spectacles may soon be a thing of the past. A new lens implant for cataracts that corrects both distance and near vision, allowing 80 percent of patients to see clearly after surgery without wearing glasses or bifocals, is now available at the Yale Eye Center.

“It really represents a whole new technological advance, because it’s able to provide patients with a quality range of vision, both near and distance, all in one optical system,” says Brian M. DeBroff, M.D., associate professor and vice chair of the Department of Ophthalmology and Visual Science. DeBroff, who has been performing lens implant surgery for more than a decade, is one of just a handful of physicians in Connecticut trained and licensed to use the new lenses.

More than 20 million people age 65 and older have cataracts, and many opt to undergo surgery to remove cloudy lenses and replace them with permanent lens implants. Cataract patients who receive implants usually see more clearly, but many still need glasses for reading. With the new lens, however, most patients achieve optimal vision that won’t deteriorate, even as the eye muscles around the lens grow weaker with age.

The new implant, known as the AcrySof ReSTOR lens, uses a technology found in microscopes and telescopes in which a series of 12 circular zones ranging in thickness from 1.3 to 0.2 microns (a human hair is 100 microns thick) allows the lens to focus light from both near and distant objects without relying on the muscles of the eye.

Approved by the FDA in March, the new implant has been used outside the U.S. since 2003. Although lens implants are usually used as a treatment for cataracts, in theory the new implant could also help those over 40 with presbyopia—a common condition affecting near vision in which the lenses become less elastic—who do not wish to wear reading glasses. However, DeBroff says he would not recommend the new lens implants for patients with a high degree of astigmatism or those who do a lot of night driving, because they cause some patients to experience halos around lights.

DeBroff performed his first implant surgery with the new lens in September, and he soon hopes to conduct a study on its use in pediatric cataract patients. Though the surgery to implant the new lens is similar to the procedure used for traditional lenses, doctors must undergo special training on taking proper measurements to achieve the best results.

“One of the important aspects of this implant is the necessity to determine very accurately the power of the lens for the individual patient,” DeBroff says. “At the Yale Eye Center we have some sophisticated equipment that uses computerization to determine the proper power of the implant to put in place once the cataract is removed.”