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The ability to focus at various distances is called "accommodation" and is the normal condition of a youthful eye’s natural lens. However, as we age, this lens becomes more rigid and our ability to accommodate diminishes, usually starting around the age of forty. This reduced ability to accommodate is called "presbyopia". Presbyopia is the reason that reading glasses or bifocals are required as we age.
Aging also causes the eye's natural lens to become more opaque, which scatters light and creates cloudy vision. The opaque lens is called a "cataract". More than half of Americans 65 and older have cataracts. Traditionally, when a cataract develops, the human lens is replaced with an artificial lens inside the eye. Standard lens implants allows optimum vision without glasses for one distance only, typically for seeing far away (distance vision). Glasses are still usually needed for close-up vision.
Monovision, often achieved through blended vision (where one eye is focused for distance and the other eye for intermediate near) is sometimes a good compromise for average daily activities, but still requires prescription glasses for fine visual tasks that require better depth perception.
The AcrySof ReSTOR IOL represents breakthrough technology because it treats the refractive problem of presbyopia. The ReSTOR lens uses a new strategy for collecting and distributing light that doesn't rely on the ciliary muscle, the muscle that controls the flexing of the inside lens, which looses its effectiveness with age.
Other accommodative-type intraocular lenses produce vision at various ranges by depending on the action of the eye's muscles to produce accommodation. However, the ReSTOR lens provides different ranges of vision based on a lens configuration that enables specific distribution of light.
Previous attempts using various multifocal lenses often resulted in haloes and significantly reduced contrast sensitivity in low light conditions. These issues have been significantly improved with the ReSTOR lens. As well, unlike the blended vision monofocal implant option; there is no loss of depth perception. Reading ability, even for fine print, is typically markedly improved with the ReSTOR.
Medicare has announced revisions to some of its payment guidelines, allowing patients covered for cataract surgery to choose the ReSTOR lens at an added fee. Previous Medicare payment rules did not allow patients to choose this lens, which is significant since the lens was specifically designed for this age group.
The ReSTOR lens and the care associated with the surgery to implant it treats the non-covered refractive diagnosis of presbyopia. For the first time, Medicare is now allowing patients to choose this elective refractive service. Patients with cataracts will still have their basic surgery covered by Medicare and/or insurance (minus any applicable co-pays or deductibles), plus they may elect to pay out of pocket for the upgrade of the ReSTOR lens and presbyopia treatment.
Refractive lens exchange, surgery patients without cataract who wish to be less dependent on glasses, would be responsible for the whole fee as usual.
This new artificial lens, which often can restore sight at near and distant ranges following cataract surgery, has received United States Food and Drug Administration approval. The clinical studies supporting its approval showed that 80 percent of patients who received the AcrySof ReSTOR lens did not use glasses for any activities after cataract surgery. Only 8% of standard monofocal IOL patients were free from glasses in the FDA study, indicating that patients who choose the ReSTOR lens have significantly better odds at achieving glasses independence.
If you are interested in seeing your best without glasses please contact Harvard Eye so that we can evaluate the appropriateness of this technology for you. Together, we can further discuss the benefits, risks and costs.
As always, Harvard Eye is first and foremost concerned about what is best for each individual patient. Call us today for your personalized consultation!
Harvard Eye Associates
Laguna Hills Office
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24401 Calle de la Louisa
Laguna Hills, California 92653
Harvard Eye Associates
San Clemente Office
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665 Camino de los Mares
San Clemente, California 92673
The eye doctors of Harvard Eye Associates perform advanced technology diagnostic testing and treatment, as well as taking the time necessary to provide each patient with information needed to fully understand his or her condition and to achieve the best possible visual outcome.
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