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Visions of Youth 

New lens implants help cataract sufferers see like they did long ago

The eyes are the first to go. By their mid-40s most people are compelled to make dramatic gyrations or succumb to using reading glasses to accomplish a simple task like reading a restaurant menu. Eventually, as if to add insult to injury, that far-sightedness will be accompanied by cataracts, further blurring and obscuring vision. For years, doctors have been removing cataracts and replacing patients’ cloudy lenses with artificial ones. Lens implants were fashioned to correct intermediate and far-range vision, but they couldn’t help with the up-close vision needed for reading. That’s all changed with the development of lens implants that correct vision at all distances.

“People are pretty excited about it,” says Dr. Randall Jacobson, an ophthalmologist with Spokane Eye Clinic. “Eighty percent of people are able to do everything they want to do without glasses.”

“I know everybody’s envious because I’m not wearing glasses,” says Judy Valkenaar, who had the surgery in 2007. “I’m just amazed.” Prior to the surgery, Valkenaar says she needed glasses for reading and driving. “My vision was getting really bad.” Upon learning she was a candidate for the lens implants, she decided to try them.

A traditional lens implant used in cataract surgery has the same correction throughout the lens, so most people still require glasses even after the surgery. With the new lens implants, there are rings of different refractivity throughout the lens, not unlike the different corrections available in a bifocal glasses lens.

Because the lens implants don’t function like natural lenses by changing shape based on where the eyes are focused, the brain has to learn to use them. “There’s a period of neuroadaptation,” says Jacobson. “It isn’t anything that the patient has to figure out, it is just that the brain has to figure it out.” That means it may take a few weeks or months for patients to realize the full benefit of their new lenses, although they will immediately notice some improvements.

Another problem that usually subsides over time is excessive glare or a halo effect around lights, especially at nighttime.

The lens implants may not be appropriate for people with eye diseases such as glaucoma or macular degeneration. But cost remains the biggest obstacle as the lenses themselves are not covered by insurance, although the surgery to implant them is. The lenses cost about $2,000 per eye, and it is important to do both eyes within a fairly short period of time. But Jacobson points out that in most cases, patients won’t need to buy prescription glasses for the rest of their lives. And he says the cost is not out of line with other elective medical procedures, such as cosmetic surgery or dentistry.

Even people without cataracts may opt for the lens implants, although they’ll have to pick up the whole tab for the surgery. “Right now these lenses are the only surgical option to get good distance and near vision. Lasik does not do that,” says Jacobson.

Valkenaar says she’s just happy not to be digging glasses out of her purse at restaurants. There’s just one problem, though. “Now I have to read for everybody else who doesn’t carry their glasses. But that’s okay, I don’t mind.”

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