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Standard posterior chamber IOL for hyperopia (e.g., Clariflex, Sensar AR40e, Advanced Medical Optics, Santa Ana, CA) is considered medically necessary.
Aetna considers aspheric monofocal posterior chamber IOLs medically necessary for aphakia (e.g., Acry Sof IQ IOL (Alcon Surgical, Fort Worth, TX), Alcon CZ70BD, SN6CWS, Tecnis (Z9000, Z9001, Z9002, ZA9003, Abbott Medical Optics, Santa Ana, CA), Sof Port AO IOL (Bausch & Lomb, Rochester, NY), Sofport LI61AO, Akreos AO Aspheric IOL (Bausch & Lomb, Rochester, NY), Akreos SA 060, Hoya PY-60AD (Hoya Surgical Optics Gmb H, Frankfurt, Germany), Abbott ZLB00, Tecnis AMO Aspheric IOL ZCB00 (Abbott Medical Optics, Santa Ana, CA), and Acrysof IQ SN60WS (Alcon Surgical, Fort Worth, TX)).
The intra-ocular lens (IOL) is a permanent plastic lens implanted inside the eye to replace the crystalline lens.
Dick (2005) stated that the potential clinical benefits of accommodative IOL technology for both cataract patients and refractive patients may place accommodative IOLs in a competitive position with multi-focal IOL technology.
The guideline included findings concerning pre-operative testing, cataract removal surgery, and post-operative issues.
A cataract is a hardening and opacification (or clouding) of the normally transparent crystalline lens within the eye behind the pupil.
This condition usually occurs as a part of the aging process, developing on a continuum extending from minimal changes in the crystalline lens to the extreme stage of total opacification.
Rarely, a cataract may form within months when related to trauma, inflammation or use of some medications.
The degree of loss depends on the location of the cataract, its size, and its density. Nuclear cataracts are located in the central substance of the lens.
The new technology lens itself would be non-covered.
This assessment of cataract surgery is supported by the Clinical Practice Guideline No.
The most common cataract that produces this type of light-related visual loss is a centrally located posterior subcapsular plaque (PSCP).
: Aetna considers standard fixed monofocal posterior chamber IOLs medically necessary for aphakia (e.g., Akreos posterior fixed monofocal IOL (Bausch & Lomb, Rochester, NY), Akreos AO Micro Incision Lens (Model MI60L), Acry Sof SA60AT monofocal IOL (Alcon Surgical, Fort Worth, TX), Acry Sof MA60AC, Acry Sof SN60AT, Alcon MZ30BD, Cee On Edge (Pharmacia Corp., Peepack, NJ), Tecnis monofocal IOL (Model PCB00), and the Hydroview hydrogel foldable posterior IOL (Bausch & Lomb, Rochester, NY)).