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What is Custom Cataract Surgery?

By customizing cataract surgery, the doctors at San Francisco Eye Institute can help correct patients’ vision beyond what can be achieved by simply eliminating cataracts. We can improve the accuracy and precision of cataract surgery using advanced technology such as the Pentacam AXL Wave and ORA with VerifEye™, which are especially beneficial for patients whose eyes have already been altered by previous refractive surgery. Using premium IOLs, we are able to correct common refractive errors including astigmatism and presbyopia, helping patients to potentially achieve crisper, clearer vision than they had even before they were affected by cataracts. Yet another way our patients are able to customize cataract surgery is by combining their procedure with iLux® treatment for dry eye, which can improve their results and enhance their comfort during cataract surgery recovery and well into the future.

Custom Vision Package

Our surgeons may recommend the Custom Vision Package for cataract patients who have previously undergone a refractive surgery procedure like LASIK or PRK. Cataract surgery can be more difficult to perform on patients who have had vision correction surgery since the eye has already been manipulated by a laser or blade to improve vision. At San Francisco Eye Institute, we can optimize the pre-operative IOL selection using the latest in cataract refractive surgery technology called the Pentecam AXL Wave. We then refine the process during surgery using ORA with VerifEye™, which provides real-time surgical measurements that allow us to more precisely select the proper lens implant power and placement during cataract surgery. When used during cataract surgery, this specialized surgical confirmation helps surgeons ensure the best results and optimal vision correction for our patients who have previously had refractive surgery or who rely on glasses or contacts to correct refractive errors.

As part of our Custom Vision Package, we also offer the option for Monovision or Mini-Monovision during cataract surgery, a solution that can help reduce or eliminate the need for eyewear after surgery. Monovision is a technique where the surgeon implants standard, monofocal lenses, where one eye is corrected for near and the other eye is corrected for distance, and the eyes work together to see at an increased range of vision. Mini-Monovision, also known as Blended Vision, uses a similar technique but results in a slightly reduced range of vision compared to the full Monovision. Mini-Monovision may be a good option for those who do not tolerate full Monovision in a contact lens trial.

Custom Vision for Astigmatism Package

Astigmatism is a common refractive error that is caused by an irregular curvature of the cornea and it makes images appear blurry or distorted at all distances. Our Custom Vision for Astigmatism Package can decrease your dependence on glasses by correcting astigmatism during cataract surgery using a combination of advanced technology and surgical techniques including the Pentacam AXL Wave, ORA with VerifEye™, Toric IOLs, and limbal-relaxing incisions. With this package, your surgeon at San Francisco Eye Institute will find the solution that is best for your astigmatism correction during cataract surgery.

astigmatism graphic

Custom Vision for Presbyopia Package

Our Presbyopia Package is ideal for patients who seek to reduce or even eliminate their need for glasses or contacts for clearer vision at all distances after cataract surgery. As the eye ages, the lens loses flexibility and is not able to focus on near vision as effectively. This condition is called presbyopia, or age-related near vision loss, and begins to affect most people after the age of 40.

Through our Presbyopia Package, we offer a number of advanced technologies and techniques including the use of the Pentacam AXL Wave, ORA with VerifEye™, and Presbyopia-Correcting IOLs that can correct vision at near, intermediate, and distant ranges. The Presbyopia Package also includes correction of mild to moderate degrees of astigmatism. Our surgeons work closely with you to determine whether you are a candidate for the Presbyopia Package and will help find the best solution for you to achieve the most visual freedom.

middle aged woman running in a park

Custom Cataract Surgery with iLux® Treatment for Dry Eye

Chronic dry eye is a frustrating and uncomfortable condition that is often caused by meibomian gland dysfunction (MGD). When the meibomian glands don’t work properly or become blocked (the cause of up to 85% of chronic dry eye symptoms), the eyes can become red, itchy, gritty, or even water too much. Dry eyes can often affect cataract measurements leading to errors in IOL selection or even blurry vision and delayed healing after cataract surgery.

For our patients who have cataracts as well as chronic dry eye, we are pleased to offer effective, non-invasive dry eye treatment with the Systane® iLux® device by Alcon, which helps us optimize measurements and results, improves healing, and offers additional benefits. This treatment can be performed before cataract surgery and involves the application of therapeutic heat and gentle massage to unblock clogged meibomian glands. After a single iLux treatment, our patients notice a marked and progressive decrease in irritating dry eye symptoms.1,2 The iLux treatment may be combined with any Custom Vision package.

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Which Package is Right for Me?

The best way to determine which type of custom cataract surgery will meet your needs is to undergo a thorough examination with an experienced surgeon at San Francisco Eye Institute. Once your refractive error has been properly diagnosed, you can have a frank discussion with your doctor about your vision goals. Together, you will be able to decide on the right Custom Vision Package for you.

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To learn more about customized cataract surgery that can help you reduce your dependence on glasses or contacts, please contact us at San Francisco Eye Institute to schedule a consultation with an experienced ophthalmologist.

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1 Lemp MA, Crews LA, Bron AJ, Foulks GN, Sullivan BD. Distribution of aqueous-deficient and evaporative dry eye in a clinic-based patient cohort: a retrospective study. Cornea. 2012 May;31(5):472-8. doi: 10.1097/ICO.0b013e318225415a. PMID: 22378109. Available: https://pubmed.ncbi.nlm.nih.gov/22378109/. Accessed May 10, 2021.

2 Tauber J, Owen J, Bloomenstein M, Hovanesian J, Bullimore MA. Comparison of the iLUX and the LipiFlow for the Treatment of Meibomian Gland Dysfunction and Symptoms: A Randomized Clinical Trial. Clin Ophthalmol. 2020 Feb 12;14:405-418. doi: 10.2147/OPTH.S234008. PMID: 32103887; PMCID: PMC7024784. Available: https://pubmed.ncbi.nlm.nih.gov/32103887/. Accessed May 10, 2021.

The doctors at San Francisco Eye Institute have either authored or reviewed and approved this content.

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