Cataract Surgery and Intraocular Lens Choices for “Fighter Pilot Vision”

  • Published
  • By Maj. Aaron C. Hager, MD
  • 6th Medical Operations Squadron

MACDILL AIR FORCE BASE, Fla.--Cataracts affect about 25 million Americans and occur when an individual’s natural lens becomes cloudy over time. They can cause blurry or cloudy vision, dim vision, and/or glare and halos at night. They can also lead to a significant decrease in a person’s ability to perform activities of daily living in a safe manner.

The solution for this problem is cataract surgery.

Cataract surgery is an outpatient procedure which typically takes less than 20 minutes. During this operation, the cloudy natural lens is removed and replaced with an artificial intraocular lens (IOL). There are several different classes of IOLs to choose from and your eye surgeon can help you decide on the most appropriate lens for you.

Here are some ideas to consider as a starting point:

Cost: Medicare and Tricare cover the cost of the traditional monofocal intraocular lens, but most insurance companies do not cover any of the “premium” IOLs. The monofocal lenses provide the highest quality of image, but at only one distance. Most patients who choose this option desire to be able to see well with no glasses at distance and wear glasses for reading and computer distances.

Intermediate vision: If you spend much of your day participating in intermediate distance activities, such as working on a computer, your eye surgeon may recommend using different strength monofocal lenses for monovision. This is where one eye sees well at distance and the other eye sees well up close. This may be a good option for many, but may not be ideal for those who require perfect vision out of both eyes.

Independence from glasses: The newer “premium” IOLs include multifocal lenses which give patients a range of vision from distance to near. These can reduce or even eliminate the need for glasses or contacts altogether. These lenses are much more expensive and are not typically covered by insurance.

Night driving: If you frequently drive at night, the multifocal lens may not be the best option for you. The multifocal lenses, especially the higher power ones, can induce glare and halos around lights. Most people adapt to these symptoms, but if you frequently drive at night, you may want to consider a monofocal lens.

Astigmatism: Astigmatism is a problem where the front surface of the eye (the cornea) is shaped more like a football than a basketball. This leads to the image formed on the film of the eye (the retina) being out of focus without glasses or contacts. If you have moderate to severe astigmatism, there are IOLs that may correct much or all of the astigmatism, enabling you to have much more clear vision. Patients with significant astigmatism are very happy with these astigmatism correcting IOLs. However, these IOLs are considered “premium” IOLs and are not typically covered by insurance companies either.

The MacDill AFB Clinic has two eye surgeons who are committed to providing the best possible eye care to active duty, their dependents, and retirees. We have the very best diagnostic and therapeutic equipment and all of our patients have access to whatever IOL the surgeon and patient feel would be most appropriate, regardless of whether it is a standard IOL or a premium IOL at no cost to the patient.

We pride ourselves in our excellent visual outcomes and do everything in our power to give you the best possible experience.

Please feel free to call the clinic for more information, including how to set up a cataract evaluation, at 813-827-9140.