B&L Akreos Intraocular Lens
Understanding the B&L Akreos Intraocular Lens
The Akreos IOL is a small artificial lens made from a special acrylic material that your body accepts well. When your natural lens becomes cloudy from cataracts or needs to be removed for another reason, we replace it with this clear artificial lens during a surgical procedure. The lens sits inside the capsular bag behind the iris, where your natural lens used to be. During surgery, we preserve the thin capsule that surrounded your natural lens whenever possible, as it provides stable support for the new implant.
Once in place, the Akreos lens bends light rays so they focus correctly on your retina at the back of your eye. This helps restore clear vision that cataracts or other lens problems have taken away. The lens stays permanently in your eye and does not need cleaning or adjustment by you, though regular eye exams remain important for monitoring your overall eye health.
We most commonly recommend the Akreos IOL for patients undergoing cataract surgery. Cataracts develop when proteins in your natural lens break down and clump together, making the lens cloudy and blocking light from reaching your retina clearly. The only effective treatment for cataracts is surgical removal of the cloudy lens and replacement with an IOL.
- You have cataracts that interfere with daily activities like reading or driving
- Your natural lens has been damaged by injury or disease
- You have another eye condition that requires lens replacement
- Previous eye surgery makes the Akreos design particularly suitable for your eye anatomy
The Akreos family includes several lens models designed for different patient needs. The most common is the Akreos monofocal lens, which provides clear vision at one distance, typically for far away objects. We select from models with features based on your specific eye anatomy and surgical plan.
- Aspheric optics for contrast sensitivity and reduction of certain optical aberrations
- Design intended for stable positioning and centration in the capsular bag
- Incision size and injector compatibility tailored to surgical technique
- Not a presbyopia-correcting design, so reading glasses are typically needed for near tasks
- Some IOLs offer blue-light filtering; availability depends on the specific model
Each Akreos model is available in different strengths, measured in units called diopters. We calculate the exact power you need based on precise measurements of your eye taken before surgery. This customization helps ensure the best possible vision correction for your specific eyes.
Determining If the Akreos Lens Is Right for You
Most patients undergoing cataract surgery are good candidates for an Akreos lens. This lens works particularly well for people who want reliable distance vision correction with a lens that has a track record of safety and effectiveness. Many surgeons choose Akreos lenses because they are familiar with the implantation technique and outcomes.
Patients who prefer straightforward vision correction without the visual compromises that can come with more complex lens designs often do very well with Akreos lenses. You may be an excellent candidate if you are comfortable wearing reading glasses for close work after surgery, since the standard Akreos is a monofocal lens.
Before we can recommend the right Akreos lens for you, we perform several important measurements of your eyes. These tests help us calculate the correct lens power and confirm that your eyes are healthy enough for surgery. The measurements are painless and typically take less than an hour to complete.
- Optical biometry to measure your eye length and shape
- Corneal topography to map the surface curve of your cornea
- Dilated eye examination to check your retina and optic nerve
- Measurement of your current eyeglass prescription
- Assessment of your tear film and eye surface health
Certain eye conditions and health issues can influence whether an Akreos lens is the best choice for you. We carefully review your complete medical and eye history before making our recommendation. Some conditions do not prevent you from getting an Akreos IOL but may require special planning or a specific model within the Akreos family.
Conditions like glaucoma, macular degeneration, diabetic eye disease, or previous eye surgeries can all affect lens selection and the vision results you can expect. We discuss these factors with you during your consultation to set realistic expectations and choose the most appropriate lens option.
Akreos-Specific Considerations
The Akreos lens is made from a hydrophilic acrylic material in many of its product versions. While this material is biocompatible and works well for most patients, there are specific scenarios where it may not be the ideal choice. If you have a history of corneal problems that might require future transplant surgery, especially procedures that use air or gas inside the eye, or if you have retinal conditions that may need surgery involving intraocular gas or silicone oil, we need to discuss these factors carefully.
In rare cases, certain types of hydrophilic acrylic IOLs have been associated with calcification or opacification when exposed to intraocular air or gas during subsequent eye surgeries. During your consultation, we will review your medical and eye history, including any likelihood of future corneal or retinal procedures, to help determine if the Akreos platform is well-suited to your long-term eye health needs.
While the Akreos lens is an excellent choice for many patients, certain situations may lead us to recommend a different IOL. We base our recommendation on your individual anatomy, visual goals, medical history, and any future eye care you may need.
- High likelihood of future intraocular gas use during corneal or retinal surgery
- Certain types of corneal endothelial disease requiring specific surgical planning
- Desire for astigmatism correction without relying on postoperative glasses, which may require a toric IOL option
- Desire for reduced dependence on reading glasses, which may prompt consideration of presbyopia-correcting lenses like multifocal or extended depth of focus designs
Comparing Your IOL Options
The Akreos lens is one of many IOL options available today. Compared to premium multifocal or extended depth of focus lenses, the Akreos monofocal design is simpler and typically causes fewer visual side effects like halos or glare around lights at night in the long term. However, you will likely need reading glasses for close tasks. It is important to note that halos and glare can still occur early after surgery as your eye heals, and factors like dry eye or residual refractive error can also contribute to these symptoms.
- Often lower out-of-pocket cost than many premium options; coverage varies by plan and whether the feature is considered elective
- Fewer nighttime visual disturbances in the long term than complex multifocal lens designs
- Excellent optical clarity for distance vision
- Long-term safety data with many successful implantations worldwide
During your consultation, we talk openly about what you can expect after receiving an Akreos lens. Most patients achieve good distance vision without glasses for activities like driving, watching television, and recognizing faces across a room. For reading, computer work, and other close tasks, you will need reading glasses or bifocals.
We also discuss how long it takes for your vision to improve, what the recovery process involves, and any limitations the lens may have. Understanding these details helps you make an informed decision about your eye care and prepares you mentally for the surgery and recovery period ahead.
What to Expect During Akreos Lens Implantation
In the days before your surgery, some surgeons prescribe antibiotic eye drops to reduce the risk of infection, though practices vary and many rely primarily on antibiotics given during the procedure itself. You will receive detailed instructions about which medications to take or avoid on surgery day. Follow the anesthesia or surgery center instructions about eating and drinking, as requirements vary depending on the type of sedation planned.
- Arrange for someone to drive you home after surgery
- Wear comfortable, loose-fitting clothing
- Remove all eye makeup and do not apply lotions to your face
- Take your regular medications unless we instruct otherwise, and confirm which ones to take the morning of surgery with small sips of water
- Disclose your full medication history, including alpha-blocker medications like tamsulosin and any blood thinners, so the surgical team can plan appropriately
- Bring your prescribed eye drops to the surgery center if instructed
On surgery day, we first apply numbing drops to your eye so discomfort is minimal during the procedure. Using a surgical microscope for magnification, we make a tiny opening at the edge of your cornea. Through this small incision, we use phacoemulsification, an ultrasound-based technique, to break up your cloudy natural lens and gently remove it from the capsule. Some surgery centers may use a femtosecond laser to assist with select steps of the procedure.
Once the natural lens is removed, we fold the Akreos IOL and insert it through the same small incision. The lens unfolds inside the capsule and we position it carefully so it stays centered. Because the incision is so small, it usually seals on its own. In some cases, a stitch may be used to ensure proper closure, though this is uncommon. We place a protective shield over your eye to keep it safe as you begin healing.
Most Akreos lens implantations are performed using numbing eye drops, sometimes combined with a mild sedative to help you relax. You remain awake during the procedure and pain is uncommon, though you may feel pressure, touch sensations, or mild discomfort. Some patients notice bright lights and movement, which are normal parts of the experience.
If you feel anxious about being awake during eye surgery, let us know during your pre-operative visit. We can provide additional relaxation medication to help you stay calm and comfortable throughout the procedure. Your comfort and safety are our top priorities.
The actual surgical time for Akreos lens implantation typically ranges from 15 to 30 minutes per eye. However, you should plan to be at the surgery center for two to three hours total when you include preparation time, the procedure itself, and initial recovery. We monitor you for a short period after surgery before releasing you to go home with your driver.
If you need cataract surgery in both eyes, we usually perform the procedures on separate days, typically one to two weeks apart. This approach allows one eye to heal before we operate on the second eye and helps us adjust the lens power in the second eye if needed based on results from the first.
Recovery and Caring for Your Eyes After Surgery
Immediately after surgery, your vision will be blurry and you may notice glare or halos around lights early on. Contact us if these symptoms worsen instead of improving. We send you home with a protective eye shield to wear while sleeping for the first week. This shield prevents you from accidentally rubbing or pressing on your eye during the night when you are not aware of your movements.
- Rest with your head elevated for the remainder of surgery day
- Avoid bending over, lifting heavy objects, or straining
- Start your prescribed eye drops according to our instructions
- Keep the protective shield in place except when putting in drops
- Do not drive until your surgeon confirms it is safe
- Contact us immediately if you experience severe pain or sudden vision loss
After your Akreos lens implantation, we prescribe eye drops to prevent infection and reduce inflammation. You will typically use antibiotic drops and anti-inflammatory drops on a specific schedule for several weeks. Proper use of these medications is critical to your healing and final vision outcome.
To apply drops correctly, tilt your head back and pull down your lower eyelid to create a small pocket. Squeeze one drop into the pocket without letting the bottle tip touch your eye or eyelid. Close your eye gently for a minute to let the medicine absorb. If you need to use more than one type of drop, wait at least five minutes between different medications.
During the first week after surgery, protect your healing eye by avoiding activities that could introduce infection or cause injury. We provide you with a detailed list of restrictions. You can shower and wash your hair, but keep your face out of the direct stream and avoid getting water in your eye. Avoid dusty or dirty environments where particles could irritate your healing eye.
- No swimming, hot tubs, or submerging your head in water for at least two weeks
- Avoid rubbing or pressing on your eye
- Do not wear eye makeup for about one week or as your surgeon directs
- Do not engage in contact sports or vigorous exercise for several weeks
- Wear sunglasses outdoors to protect your eye from bright light and dust
We see you for your first follow-up visit the day after your surgery to check how your eye is healing and measure your vision. Additional appointments are typically scheduled at one week, one month, and three months after surgery. These visits let us monitor your recovery, adjust your eye drop schedule, and address any concerns you have.
Come to every scheduled follow-up appointment, even if your eye feels fine and your vision seems good. Some complications develop without obvious symptoms, and early detection during these exams can prevent serious problems. We also use these visits to determine when you can resume normal activities and when to prescribe new glasses if needed.
Most patients notice significant vision improvement within a few days after Akreos lens implantation, but your vision continues to change as your eye heals. Minor fluctuations in clarity are normal during the first several weeks. Your vision typically stabilizes enough for a new eyeglass prescription within four to six weeks after surgery.
Complete healing and final vision outcomes usually occur by three months after your procedure. At that point, we perform a comprehensive eye exam and update your prescription if you need glasses for reading or fine-tuning your distance vision. Some patients find their vision continues to improve slightly even after the three-month mark as any remaining inflammation resolves.
Potential Complications and Warning Signs
After Akreos lens implantation, many patients experience some mild and temporary side effects as the eye heals. Blurry vision, light sensitivity, mild discomfort, and a scratchy feeling are common for the first few days. Your eye may also produce more tears than usual or feel slightly dry at different times. Fluctuating vision from dry eye or mild corneal swelling causing foggy vision can also occur early on.
- Seeing glare or halos around lights, especially at night, during the initial healing period
- Redness on the white part of your eye near the incision
- Feeling like something is in your eye
- Mild itching or sticky discharge in the morning
While serious complications after Akreos lens surgery are uncommon, you need to recognize warning signs that require urgent evaluation. Contact our office or seek emergency eye care immediately if you experience severe pain that is not relieved by over-the-counter pain medication, eye pain accompanied by nausea or vomiting, sudden vision loss, rapidly worsening light sensitivity, or sudden drop in vision after initial improvement.
Other urgent warning signs include flashing lights or new floating spots in your vision, a curtain or shadow blocking part of your visual field, or discharge that is thick, yellow, or green in color. These symptoms could indicate infection, bleeding, retinal detachment, elevated eye pressure, or other serious complications that need prompt treatment to protect your vision. If you cannot reach our office promptly, seek emergency eye care at an urgent eye clinic or hospital emergency department.
Long-term complications after Akreos lens implantation are uncommon, but we continue to monitor your eyes at regular comprehensive exams even after your initial recovery is complete. Potential risks that can develop months or years after surgery include inflammation inside the eye, lens dislocation, retinal detachment, cystoid macular edema, corneal edema or decompensation in patients with pre-existing corneal conditions, or worsening of pre-existing conditions like glaucoma or macular degeneration.
Other concerns that may arise over time include persistent visual phenomena such as positive or negative dysphotopsias, which are unwanted light effects or shadows in your peripheral vision, residual refractive error requiring glasses or contact lenses, or in some cases enhancement procedures. Chronic dry eye symptoms can also affect your visual satisfaction after surgery. During your annual eye exams, we check the position and clarity of your Akreos lens, measure your eye pressure, and examine your retina thoroughly. Regular monitoring helps us detect and treat any problems early, often before they cause noticeable symptoms or permanent damage to your vision.
The most common long-term issue after any IOL implantation, including the Akreos lens, is posterior capsule opacification, or PCO. This occurs when the thin capsule that holds your lens becomes cloudy over time, causing your vision to blur gradually. Some people call this a secondary cataract, although it is not actually a new cataract forming.
If you develop PCO, we can restore your clear vision with a quick laser procedure called YAG laser capsulotomy. This treatment takes only a few minutes in our office and requires no incisions. We use a focused laser beam to create a small opening in the cloudy capsule, allowing light to reach your retina clearly again. While the procedure has minimal downtime, your vision may be temporarily blurry immediately afterward, and you may notice new floaters. We will check your eye pressure after the procedure and may prescribe anti-inflammatory drops for a few days. The procedure carries small risks including eye pressure elevation, inflammation, retinal detachment, and rarely damage to the IOL itself, though serious complications are uncommon. Many patients notice vision improvement within a day, though timing varies.
Frequently Asked Questions
Most patients who receive a standard Akreos monofocal lens will need reading glasses for close-up tasks like reading small print, using a smartphone, or doing detailed craft work. We typically set the lens power to give you clear distance vision without glasses, but this means you will need help for near vision. Some patients choose to have one eye set for distance and one for near, an approach called monovision, though this option depends on your lifestyle, visual preferences, and ability to adapt to the difference between eyes.
Your Akreos intraocular lens is designed to last for the rest of your life once it is implanted. The lens material does not break down or wear out over time like your natural lens did. The IOL itself rarely requires exchange or replacement, though specific medical situations can differ. If your vision becomes cloudy years after surgery, it is more often due to posterior capsule opacification, a clouding of the capsule behind the lens rather than the IOL material itself, and this can be treated with a simple laser procedure as described earlier.
While the Akreos lens is meant to be permanent, it can be removed or exchanged if a medical need arises. Reasons for lens removal or exchange might include incorrect lens power calculation, lens dislocation, chronic inflammation, or a desire to upgrade to a different lens type. However, IOL exchange is a more complex procedure than the original implantation and carries additional risks, so we only recommend it when medically necessary or highly beneficial.
When cataract surgery is medically necessary, Medicare and most private insurance plans cover the cost of a standard monofocal IOL like the Akreos lens as part of the cataract surgery procedure. You may have copayments or deductibles according to your specific insurance plan. If you choose upgraded testing or premium lens options beyond the standard of care, you may have additional out-of-pocket costs that insurance does not cover. It is important to note that refractive lens exchange, or RLE, which is lens replacement for refractive purposes when medically significant cataracts are not present, is typically considered elective and is not covered by insurance in the same way that medically necessary cataract surgery is.
Astigmatism is a common condition where your cornea has an irregular curve that blurs vision at all distances. We have several options to address astigmatism when you undergo cataract surgery. If you have mild astigmatism, we may be able to reduce it during your cataract surgery by placing the incision in a specific location or by making small additional incisions called limbal relaxing incisions or arcuate keratotomy. For higher amounts of astigmatism, we might recommend a toric IOL designed specifically to correct astigmatism, if appropriate and available, or we can plan for you to wear glasses or contact lenses after surgery to correct the remaining astigmatism and give you the sharpest possible vision. In select cases, laser vision correction may be an option after your eye has healed if residual astigmatism affects your quality of vision.
Getting Help for B&L Akreos
If you have been told you need cataract surgery or lens replacement, schedule a consultation with our eye doctor to discuss whether the Akreos IOL is right for your vision needs. We will perform a complete eye examination, take precise measurements, review your health history including any prior or potential future corneal or retinal procedures and your current medications such as alpha-blockers, and explain all your lens options so you can make the best decision for your eyes and lifestyle.