Customized Vision: The Evolution of Intraocular Lenses in Cataract Surgery

close up of person's eye with cataract

Intraocular lenses (IOLs) are relatively recent innovations in cataract surgery. These ophthalmology advancements allow patients to enjoy customized vision results. Lens implant technology has improved vastly from its original one-size-fits-all approach.

To understand just how effective and innovative modern IOLs are, it’s helpful to understand what cataracts are in the first place, the history of cataract surgery, and the evolution of IOLs. That includes what they are and how they work.

Here at the Atlanta Vision Institute, we’re pleased to offer a wide range of vision correction treatments and procedures. Included among them is the insertion of IOLs through a procedure called Clear Lens Exchange. 

If you think you may be a candidate for a vision correction procedure, you can schedule a free virtual consultation and we’ll determine what procedures are best for you.

What Are Cataracts and What Causes Them?

A cataract is a cloudy spot that develops in the lens of the eye. Cataracts develop slowly and can occur in one or both eyes, and they lead to a decrease in vision.

Symptoms of cataracts, aside from a noticeable cloudy spot in the eye, include blurred vision, faded colors, halos around light sources, trouble viewing bright lights, and difficulty seeing at night. People with cataracts may have trouble driving, recognizing faces, and reading.

Other negative effects of cataracts included an elevated risk of falling and diminished self-esteem and self-confidence resulting from poor vision.

Aging is the primary factor affecting the development of cataracts, with the chances increasing as one gets older. In the United States, cataracts are responsible for 5% of the blind population. Worldwide, more than 20 million people are blind due to cataracts, with cataracts being responsible for just over 51% of cases of blindness and 33% of all vision problems.

Other causes of cataracts include blunt trauma, radiation exposure, genetics, and skin diseases (the lens is susceptible to many of the same diseases the skin is). They can also be present at birth, and sometimes they develop after eye surgery meant to correct a different problem.

There are also some risk factors that seem to increase the likelihood of a cataract developing. One of those is diabetes, and another is long standing use of certain steroidal medications. Others are alcohol, smoking tobacco, and prolonged exposure to sunlight. Another tie to a higher risk of developing cataracts is insufficient Vitamin C intake.

Wearing sunglasses and a wide-brimmed hat is a known way to reduce the risk of developing cataracts or slowing their development. Eating leafy fruits and vegetables, avoiding smoking, and reducing alcohol consumption may also have one or both of those effects.

Glasses and contact lenses may help with cataracts, but the only permanent correction for them is cataract surgery. While there are many recognizable symptoms, only an examination by a qualified medical professional can definitively diagnose a cataract.

If you suspect you may have a cataract, you can schedule a consultation with us here at the Atlanta Vision Institute.

A Brief Primer on Cataract Surgery

Cataract surgery is also referred to as lens replacement surgery. It involves the removal of the natural human eye lens, also called the crystalline lens, by emulsification or incision. Then the natural lens is replaced with an artificial lens (today, an IOL).

The procedure is highly effective. It’s usually performed as an outpatient procedure using a local anesthetic. There’s little or no pain, and the recovery time is swift. The patient is typically back to most normal activities in just days, and full recovery takes only about a month.

Cataract surgery dates back to ancient times. It’s mentioned in the Babylonian Code of Hammurabi, dating back to 1750 BCE. The ancient Egyptians seemed to practice it even earlier; a statue from about 2460 BCE depicts cataract surgery. Cataract surgery also took place in ancient India and Africa.

The method used was called couching. It involved dislodging and pushing aside the lens but not removing it. This removed the opacity, but it also removed the ability to focus. Some poorer countries still use the process, but more developed nations have all but abandoned it in favor of better practices that deliver better results.

In 1747, a French physician became the first European to successfully extract cataracts, and in 1753, an English doctor performed the first recorded removal of the entire lens and the lens capsule. By the early 20th century, most physicians used a process called intracapsular cataract extraction. This led to intracapsular cryoextraction later in the century. Both were major improvements in safety, efficiency, and success from couching.

However, the biggest breakthrough came in 1947.

The Evolution of Intraocular Lenses

In 1947, Sir Harold Ridley became the first person to successfully implant an IOL. Prior to the IOL, patients had to wear very thick glasses or a special type of contact lens after the removal of the natural lens.

Today’s IOLs are small and light lenses. They have plastic side struts called haptics to hold them in place. Effectively, they are permanent solutions; there is no having to remove and replace contact lenses daily.

Modern IOLs also are highly versatile. We’re able to tailor their performance for a wide range of distances and light conditions, hence the customized vision the process achieves. The original IOLs were not as versatile, which helps explain why they didn’t become widespread for almost 30 more years.

By the 1970s, thanks to improved lens design and surgical technique, the IOL gained widespread acceptance. Today, it’s the most common and effective form of cataract surgery. More than 4 million people undergo the procedure each year in the United States. Around the world, it’s almost 28 million.

If you suspect you need cataract surgery, or if you have vision problems and aren’t a candidate for LASIK, check your eligibility for surgery with our different available tests, which are the cataract test or the LASIK vision test at the Atlanta Vision Institute site. Start your journey to a clearer vision with us today!

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