Optional non-insured testing and special feature IOL implants

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What is a Cataract?

Cataract is an age-related progressive clouding of the natural lens inside your eye.  It causes decreased vision that can impact your ability to read, drive and function. In cataract surgery, the cataract is removed and replaced by a clear artificial implant called an intraocular lens (IOL), restoring your vision. IOL implants in cataract surgery can be used to reduce your glasses dependence.

What options do I have with cataract surgery?

Prior to cataract surgery, measurements of the length and shape of your eye are performed to help select the IOL for your surgery.

In Ontario, the standard costs associated with preoperative testing, cataract surgery, and implantation of the IOL are covered by OHIP.

With technological advancements, we now have several optional tests and special feature IOLs to help improve accuracy of implant selection and reduce your dependence on glasses after cataract surgery. Talk to your eye surgeon about the costs associated with these optional services.

Improving accuracy helps reduce the risk of selecting the wrong power IOL, which can result in wearing stronger glasses or rarely having the implant removed and replaced with the correct one.

What Preoperative tests are available?

  • A-scan: (Ultrasound measurement) A drop of freezing is placed in the eye, a probe touches the eye and measures its length.(Insured service-OHIP covered)
  • Optical biometry: (Laser measurement) Measurement of length and shape of eye which has been shown to be more accurate than A Scan and can help more accurately select the IOL implant power. (Uninsured service- not covered by OHIP)
  • Your surgeon may recommend other preoperative tests/measurements to help with accuracy in certain special feature IOLs.

What IOL options are available in cataract surgery?

There are 3 categories of IOLs that can be used in cataract surgery: monofocal, toric, and multifocal.  OHIP covers the cost of a monofocal IOL. Toric and multifocal IOLs are special feature implants that can reduce glasses dependence after surgery.  Your eye surgeon will evaluate what options are appropriate for you based on the health and condition of your eyes.

  • Monofocal IOLs allow you to see at one focal point, usually distance (driving, television). Glasses will be required to see near (reading, phone) and intermediate (computer, dashboard). If you have astigmatism and choose not to select a toric IOL then you will require full-time glasses after cataract surgery.
  • Toric IOLs are customized implants designed to reduce or eliminate astigmatism. Astigmatism is a very common condition when the surface of the eye is not round and is shaped more like an American football. A toric IOL power is selected based on non-insured preoperative measurements and allows you to see at distance without glasses. It is likely that you will still need reading glasses. 
TORIC IOL implants are aligned in cataract surgery along the patient's astigmatism axis
  • Multifocal/Extended depth of focus IOLs are customized implants designed to provide clear vision without glasses at distance, intermediate, and sometimes near, and are selected based on specialized preoperative measurements.  You may still need glasses for prolonged reading or very fine print. These implants can have some side effects, like glare and halos around lights.
Multifocal implant: concentric rings divide up light for distance, intermediate, and near focus

Cataract surgery wait times

Wait times for cataract surgery are updated quarterly, with wait 1 representing how long it takes in days to get in to see the surgeon in the office, and wait 2, how long it takes after that to get in for surgery.
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