My Cataract Surgery and How Much Crystalens Cost
Having Too Many Choices Can Be a Bad Thing
It seems like life was much simpler when I was a child. Ice cream was offered in just three flavors: vanilla, chocolate, or strawberry. That was all I needed to make me happy.
Today, there are just too many choices available. I sometimes wish for someone to just take control and tell me which options to select. This has never been truer than when I was confronted with worsening vision.
I had a cataract removed from my left eye in 2010 and wasn't too worried. Cataract surgery is the most frequently performed surgery in the United States. Each year, approximately 3 million Americans undergo this procedure, mostly with satisfactory results.
Development of Better Contact Lenses
Decades ago, patients undergoing cataract surgery had no choice but to wear thick glasses for the rest of their lives since there was nothing to replace the natural lens that had been extracted. Eventually, however, researchers developed the monofocal, intraocular lens implant followed by multifocal implants, and finally, in 2003, the Crystalens accommodating intraocular (IOL) lens implant.
The Crystalens IOL, unlike its counterparts, actually works like the eye’s natural lens. There is no fixed focal point where the eye focuses best. The lens actually mimics the adjustments that the eye muscles make when they shift from focusing on something near, like reading material, to something far, like the horizon. After weeks or months, the brain adjusts to the lens so that the transition from near to intermediate to far is seamless.
Some people who have the Crystalens implanted will enjoy freedom from glasses in most situations, with perhaps low light and very tiny print giving them difficulty. A significant proportion, however, will continue to need reading glasses.
Things to Consider as a Patient
The Crystalens has enjoyed consumer success. Globally, approximately 7 million people are walking around with this lens implanted in their cataract-free eyes.
There are so many choices now and so many more difficult decisions. You, the patient, are a very important part of the cataract surgery process, and as a consumer, you also want to find the best value for your money.
The Crystalens is an expensive, premium IOL. In fact, it is very lucrative for the ophthalmologist who sells it to you. But don’t expect to find up-to-date prices by visiting various ophthalmologists’ websites. Their websites usually give you the same marketing information that the manufacturer Bausch + Lomb's website does. Also, don't expect to get much information by calling your ophthalmologist's office. You will likely be asked to make an appointment to examine your cataracts first.
How Much Do Crystalens Typically Cost?
In addition to having the price spelled out for me at two different ophthalmologists' offices, I have investigated reports online and have spoken with individuals to get an approximate range of prices for this lens. You can expect to pay from $2500 to upwards of $3000, per eye, for your Crystalens. The cost may vary by area of the country, the length of time the doctor has been practicing, the doctor’s reputation and expertise with the Crystalens, and the amount of overhead costs in their practice.
How Are Costs Distributed?
I paid $3300, slightly more than average, to implant the Crystalens in my left eye. Here is how the cost was broken down:
- $2800 for the lens
- $500 for a co-management fee to my optometrist
Co-management with your referring optometrist is quite common with LASIK surgery, and apparently, with cataract surgery as well. However, since most people don’t need to wear glasses after they get a Crystalens, I cannot help but feel that the $500 was just my surgeon's kickback fee to my optometrist and not much more. It would be an excellent idea to inquire about these co-management possibilities when you go to your first surgical evaluation. It might save you some confusion if you are doing price comparisons between surgeons.
It is also important to be aware that different surgeons may price things differently, usually adding on costs. Some offices will charge more for the lens and collect a $1000 co-management fee. If the cataract surgeon also does a lot of Lasik surgeries, they may charge more for the Crystalens and throw in free Lasik or PRK (photorefractive keratectomy) touch-ups if you are not satisfied with your visual outcome. Essentially, you'll be paying more up-front, regardless of the need for post-operative Lasik or PRK enhancement. This could push the total cost to $4500-$5000 for one eye.
What If You Have Astigmatism?
At your first surgical evaluation, you should determine whether your ophthalmologist can include an LRI (limbal relaxing incision) in the cost for your Crystalens. If you to improve your astigmatism without any additional refractive surgery, you may want to talk to your doctor about LRI. It is a method of helping your cornea focus light by making small incisions in the cornea.
When I chose the Crystalens, my surgeon included the LRI in the purchase price. If a patient chooses any other lense, the LRI will be billed to the patient separately (it won't be covered by insurance because its purpose is refractive).
If you opt for an LRI, be certain about your insurance policy's coverage terms for this procedure. Somewhere in your consent forms, you should find a signed statement acknowledging your understanding of the costs.
If you don't have astigmatism, and you have nothing to gain from getting the premium lens implanted, I would suggest getting a monofocal lens or a diffractive lens. Talk to your surgeon about the visual outcome you are looking for and the visual outcome you can expect from each type of IOL. With a monofocal lens, the lens is either set for far vision or near vision. This means you can either see well far away or close up, not both. The Crystalens is meant to be transitional, meaning it can help with near, intermediate, and far vision. However, in some cases—and certainly in my case—this may not be 100% true.
Will Insurance Cover the Costs?
Since I wasn't old enough for Medicare, and I didn't use Medicaid, I can't be too explicit about how their reimbursements work. I do know that Medicare covers cataract surgery but will only pay up to the cost of a standard, no-frills monofocal IOL; they expect you to pay the difference for a premium lens.
I have private insurance. I can’t imagine that any standard health insurance policy would pay for a premium IOL, and in fact, mine does not. They might if it could be proven medically necessary, but that is not going to happen. 99.9% of the population will function well enough with a monofocal implant, so that’s what they will cover. I had to pay for my Crystalens out of pocket. However, your doctor's office may offer some financial assistance. My doctor’s office offered a zero-interest installment plan until the lens was paid off.
Your Eyes, Your Choice
Do your research, ask around, and weigh all of the factors; it is ultimately your choice. If you choose to get an IOL, you’re going to want an excellent surgeon to operate on your eyes. I have had two cataract evaluations from separate surgeons. If you have extra time and money, you may also wish to undergo an examination with a different doctor. Be aware, though, that a cataract evaluation is an endurance test—mine took about three hours.
If you have a co-existing abnormality, as I do with my left eye, or you have a chronic disease, you might have to go for an evaluation with a retina specialist. From your two evaluations, you should get a good sense of how well they will cooperatively manage your condition. If you feel confident about undergoing the procedure, look no further!
Is Your Doctor Pushing the Crystalens?
You will likely be talking with office staff about IOL pricing. The doctor is usually too busy to go into detail with you about this. Don't be surprised if they seem to be pushing one type of lens over another. The only person you can really trust to help you make a decision is someone who has already had cataract surgery and an IOL implant and can talk about how they have adjusted to their new lens. Whoever you talk to, take what they say with a grain of salt. Check out what they say with another surgeon or do some research on the web.
If they're pushing the Crystalens, again, listen to what they have to say, but also do your own research. However, you don't have to be overly skeptical of the Crystalens (besides the price). It's true: surgeons are generally motivated by money, but on the other hand, it may be the lens they are most comfortable implanting. Many surgeons may have specialized in implanting a certain kind of IOL. With a quick Google search, you can find Crystalens specialists in your area.
My Experience With Crystalens Implants
I researched and deliberated to the point of agonizing over whether I should have cataract surgery or put it off for another year. Sometimes, I do wish someone would just make decisions for me, or at least narrow down my options. Eventually, my retina specialist did just that. He said, “I believe your only choices are the Crystalens or a standard monofocal IOL.”
My First Cataract Surgery
Toward the end of 2009, I decided to get a Crystalens IOL implanted in my left eye after cataract surgery. The same year I also had a vitrectomy and ERM peel in the same eye that gave me back several lines of vision. The first 90 days after your procedure is spent monitoring your healing progress with your optometrist. It is important to note that you may not see improvements right away. In fact, it may take up to a year to notice improvements. My optometrist also told me that Bausch + Lomb let you know what to expect in terms of needing glasses after the procedure. In some cases, this may differ from your own expectations.
Several months after the procedure, as my retina was healing, I experienced some improvement in my vision. The Crystalens was doing what it was supposed to do! I would remove my glasses when working at the computer. However, I still had to wear glasses while driving due to the development of myopia and a cataract in my right eye. The good news is, I have had no problems with my one Crystalens so far.
A year and a half after the procedure, during a follow-up visit to my cataract surgeon, he noted that I needed a Yag laser capsulotomy because the implanted lens had thickened and had become cloudy. This is a common procedure that is done after cataract surgeries. A few months after the capsulotomy, my lens and vision in my left eye were holding up. There were some occasional floaters in my eye, but I got used to them, and they went away after a while.
My Second Cataract Surgery
I decided to have cataract surgery and another Crystalens implant in my right eye two years after my first cataract surgery. People usually have cataract surgeries weeks apart. I decided to wait longer to see how my first lens would work out. My surgeon also made LRIs—this was included in the price of the lens implant—to treat my astigmatism.
A year after my second cataract surgery, I finally had improved vision—at least for my far and intermediate vision. I still needed glasses for close vision (e.g. for reading or knitting). I couldn't read department store labels or nutrition facts on canned foods, even in fluorescent supermarket lighting.
Was the Crystalens IOL the Right Choice?
The reason I have perfect far vision is because my astigmatism was corrected through the LRIs on both corneas. These incisions were also included in the cost for my Crystalens IOLs, so although I still have to wear reading glasses to see things close up, I think that I made the right choice. The LRIs, by themselves, can total around $2500 for each eye.
This article is not meant to diagnose or treat any disease, illness, or condition and should be used for informational purposes only. Always consult a licensed healthcare professional to discuss the best course of action for your specific situation.
Questions & Answers
I have had cataract surgery on both eyes and could see pretty well afterward. Over time, it has worsened. I can't see the writing (very blurry ) on the TV. What do you suggest?
I would suggest returning to the ophthalmologist and telling him/her. Your vision should be stable, unless you begin having retinal problems.Helpful 3
© 2009 gracenotes