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Surgery Options



A cataract is a clouding of the natural lens of the eye. Cataract development is a natural aging process, though sometimes cataract progression is accelerated by various factors. If cataract development begins to significantly affect your vision, sometimes a change in your glasses prescription can improve your vision enough that surgery could be delayed. In most cases, it is also fine to "just live with" the visual symptoms from cataracts. Surgery may be considered when a change in your glasses prescription will not likely improve your vision, and you feel debilitated with your present level of visual function.

Cataract surgery involves removing the natural lens of the eye. In order to restore the focusing properties of the eye, an intraocular lens implant (IOL) is placed in the eye after the cataract is removed. IOLs are available in varying powers, and the power that is placed in your eye is based on your eye's specific measurements. For some patients, cataract surgery can reduce the need for glasses or contact lenses for distance vision, near vision, or a range in between the two.

IOLs are available in a variety of styles. The monofocal type provides good distance, intermediate, or near vision, but not all three. With this type of lens implant, most often a power is selected that will provide your individual eye with good distance vision without glasses, but in order to see for reading, you would need to wear reading glasses.

Advanced Technology IOLs can decrease your dependency on glasses by providing a fuller range of vision than monofocal IOLs. Two commonly used types include 1) Multifocal IOLs, and 2) Extended Depth of Focus IOLs. Specific examples of these IOLs available at Hecker Eye Care Associates are the Alcon Vivity IOL (Extended Depth of Focus IOL) and Alcon PanOptix (Trifocal IOL). These IOLs can reduce your need for glasses for all ranges (Multifocal IOLs), or distance and intermediate ranges (Extended Depth of Focus IOLs).

Some eyes have a condition called astigmatism, which is common and involves the presence of varying amounts of curvature on the cornea. It is normal for a person with astigmatism to be dependent on glasses or contact lenses in order to have their best vision. Astigmatism can sometimes be reduced at the time of cataract surgery with a procedure called limbal relaxing incisions. However, limbal relaxing incisions are not always the best choice. Another option for eyes with certain amounts of astigmatism is the AcrySof Toric IOL. This is a monofocal IOL which provides astigmatism correction incorporated into the IOL, thus reducing one's need for glasses postoperatively. Multifocal and Advanced Depth of Focus IOLs may also be a consideration for certain types of astigmatism correction.

As you can see, now there are many considerations and choices when it comes to meeting your visual needs with cataract surgery. It is important to know that there is never a 100% guarantee that you will not have to wear glasses any longer after cataract surgery. Even with the newer technology IOLs described above, one may still need to wear eyeglasses for certain activities such as extended reading or driving at night. However, many patients now enjoy excellent results with all of the above-described IOLs.

Cataract surgery itself has an excellent safety record, but is a decision that should be entered into with proper counseling from your eye surgeon about your potential risks and benefits. In learning your options for improved vision, it is best to begin with a comprehensive eye exam and consultation at Hecker Eye Care Associates. All of the above options are available at Hecker Eye Care Associates. Based on the results of your individual eye exam and visual needs, your eye surgeon will provide you with the information and appropriate recommendations that you need in order to see the world more clearly.

At Hecker Eye Care Associates, we take pride in providing exceptional eye care that focuses on your individual needs.


How do I know if I am a candidate for an Advanced Technology IOL? 

The best way to know is to have a consultation with Dr. Hecker or Dr. Van, after receiving a comprehensive eye examination. In general, the overall health of the eye must be good. Eye diseases such as macular degeneration, glaucoma, diabetic eye disease, or corneal diseases can limit your choices. In addition, certain types of astigmatism may not be correctable with astigmatism correcting IOLs.

What does my insurance cover? 

If a monofocal IOL is placed with cataract surgery, Medicare and most private insurance companies cover the costs (with the exception of deductibles and co-pays).

If an Advanced Technology IOL (Alcon AcrySof Toric, Tecnis Eyhance Toric, Alcon Vivity, or Alcon PanOptix) is placed with cataract surgery, the cost of cataract surgery and anesthesia generally is covered, but not the extra cost for the Advanced Technology IOL and the services provided with it. You are responsible for the added costs, which vary depending on the type of IOL you choose. Prior to your final decision regarding your IOL choice, our surgical counselor will clearly review with you your estimated costs and payment options. 

Which Advanced Technology IOL is best for me? 

Dr. Hecker and Dr. Van are happy to offer their patients the Alcon PanOptixTM and Alcon Vivity intraocular lens (IOL). 

The Alcon PanOptixTM is one of the most technologically advanced multifocal IOLs available to surgeons, and was the first trifocal IOL available. This allows for better near (reading) vision, as well as intermediate (computer work) vision compared to a monofocal lens.

In the FDA study of the IOL, 99% of patients would have the same lens implanted again. Additionally, 80% of patients found that they never needed to wear glasses over a week’s time period.

The Alcon Vivity IOL provides excellent distance and intermediate (computer) vision, but patients will likely still need to use reading glasses for near. However, this lens does not have the same degree of haloes when driving at night and provides better contrast compared to a multifocal IOL. 

To be very clear, there is a chance that you still may need glasses for distance, intermediate, and/or near vision with these IOLs. Some patients are not good candidates for this lens due to underlying ocular conditions. We are happy to discuss your options at your cataract evaluation.

To learn more, click on the following links:

AcrySof Toric:  


AcrySof ReSTOR IQ: 

Limbal Relaxing: 

Hours of operation are subject to change without notice due to covid and other circumstances beyond our control.


Hecker Eye Care Associates
1507 Westover Terrace, Suite C
Greensboro, NC 27408
Phone: 336-715-2773
Fax: 336-274-2024

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