Refractive Cataract Procedure in Billings, MT

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ABOUT Refractive Surgery

Vance Thompson Vision's board-certified vision team Dr. Thompson, Dr. Swan, Dr. Berdahl, Dr. Greenwood, Dr. Baartman, Dr. Ristvedt, and Dr. Morledge-Hampton have been involved with the refractive cataract surgery method since its clinical development. As a team dedicated to providing our patients with the most innovative and successful approaches to ocular health care, we are very proud to be among the first ophthalmology practices in the region to perform refractive cataract surgery.

This customizable cataract procedure is an enhanced version of traditional cataract-removal surgery. With extremely precise incisions and advanced artificial lenses that can correct or improve refractive errors, refractive cataract surgery offers much more to patients than being cataract-free. This variation not only improves accuracy but also simplifies the removal of the natural lens and helps to ensure a smoother healing and recovery period. We also offer a wide range of remarkably advanced intraocular lenses to fit the needs of every patient according to his or her vision needs and unique lifestyles.

At Vance Thompson Vision in Billings, MT, we make sure all of our patients are fully aware of all of their treatment options, as well as the details of those options. If you are interested in long-term freedom from cataracts and reliance on prescription glasses or contacts, call our team to set up your refractive cataract surgery consultation. 

Click here to see our 20-Point Checklist for Cataract Surgery. It provides valuable information on how quality technology can make a world of difference in cataract surgery.

Cataracts FAQs Paying for Surgery Cataracts Checklist

Best Candidates

Typically, the best candidates for cataract surgery, whether traditional or refractive, are those who have been diagnosed with cataracts, but their prescription lenses are no longer able to provide enough vision correction. However, with refractive cataract surgery, patients don't always have to wait for their cataracts to progress that far. Men and women who would like to learn whether they are candidates for the procedure at Vance Thompson Vision will need to schedule an initial consultation with a member of our doctor team. At this consultation, the doctor will perform a thorough eye exam and evaluation of the patient's medical history, lifestyle, and vision needs.


All methods of cataract surgery include the removal of the cataract, or clouded natural lens, and its replacement with an artificial intraocular lens (IOL). In refractive cataract surgery, the incision through which the lens is removed is created with highly precise surgical instruments. The surgeon is also able to break up the natural lens into smaller pieces, which allows for a much quicker and smoother removal.

At Vance Thompson Vision, we also have state-of-the-art technology that enables us to digitally map your eye prior to surgery so that your procedure is fully planned and customized to your specific eye. Once your surgeon has removed your lens, an advanced, vision-improving IOL will be inserted through the same tiny incision. You and your surgeon will have chosen your ideal IOL during consultations well ahead of your procedure. Using a combination of all of these technologies, our team of ophthalmologist surgeons can perform this amazing procedure, which can help patients stay independent and active for decades afterward.

To ensure that each patient receives the ideal implant power, we use ORA with VerifEye+ technology during the surgery to take approximately 40 more precise measurements of the eye once the natural lens is removed.

The Vance Thompson Vision ophthalmologist surgeons have been involved with this procedure, as well as other similar procedures, since clinical development. We are extremely proud that our team has been so deeply involved in the development of the innovative cataract surgery techniques that have led to refractive cataract surgery.

Types of Lenses

Monofocal Lenses

One of the most important aspects of your cataract surgery will be choosing your new IOL. In order to choose the ideal IOL for your vision and lifestyle needs, you need to know all about your IOL options.

Monofocal IOLs are designed to create a patient's clearest possible vision at one distance. The distance chosen can be near, intermediate, or far. Most of our patients who choose monofocal IOLs go with far-distance focusing and then occasionally wear reading or magnifying glasses when the need arises. We use the most advanced monofocal IOLs available.

One monofocal IOL we offer is the Wavefront-adjusted Tecnis intraocular lens. Wavefront-adjusted monofocal IOLs can provide improved functional vision, so not only do they clarify distance vision, they can also provide better night vision and contrast sensitivity.


Light Adjustable Lens Implants

The ophthalmologist surgeons at Vance Thompson Vision are proud to offer their patients an exciting new cataract surgery option called the Light Adjustable Lens (LAL). The Light Adjustable Lens enables patients and their surgeons to continue working together beyond the actual surgery to further customize and enhance individual outcomes.

For a routine cataract surgery process without the LAL, you and your surgeon would choose your IOL well ahead of surgery based on careful eye measurements, mapping, and acuity tests. Once that lens is placed and your surgery is complete, there would be very few ways to modify or customize your outcome.

The Light Adjustable Lens, made with a remarkable new material developed by a Nobel Prize-winning scientist, changes that process. An LAL cataract surgery procedure is performed in the same way as a traditional or laser cataract surgery, but the process continues once your surgery is done. This revolutionary lens technology enables your surgeon to adjust and customize your vision in the weeks after your procedure using light treatments. The Light Adjustable Lens responds to the light treatments, meaning you and your surgeon will work together during these light treatments to adjust the lens — and your vision — until you are both ready to finalize your outcome with one last light treatment. 

According to clinical study results, most patients who have cataract surgery with the LAL have outcomes of 20/20 vision or better without other corrective lenses. Being able to customize vision outcomes after cataract surgery is an incredible advantage for both patients and surgeons.

PanOptix® Lenses

As the one and only trifocal lens implant approved by the FDA, the AcrySof IQ PanOptix® trifocal IOL is an exciting new option for cataract patients and surgeons. This remarkable new lens is able to provide corrected near, intermediate, and distance vision. As a result, the PanOptix® trifocal lens can significantly decrease patients' reliance on glasses following cataract surgery compared to other IOL types.

The PanOptix® trifocal lens, which incorporates ENLIGHTEN® Optical Technology, can provide a patient's best possible intermediate vision without negatively affecting near and distance vision. Further, this unique lens technology is also available in the PanOptix® toric lens, meaning certain patients with astigmatism could also be candidates.

While the PanOptix® trifocal lens has already become a leading IOL in more than 70 countries, it has only recently been approved by the FDA for use in the US. Vance Thompson Vision was proud to participate in the FDA's clinical trials, which were conducted at only 12 specially selected U.S. sites. When the clinical trials were completed, Vance Thompson Vision facilities in South Dakota, North Dakota, Montana, and Nebraska were the first to provide patients in these states with the new lens technology. We are now excited to be able to provide the PanOptix® lens at all Vance Thompson Vision locations and are happy to pass our in-depth experience with this new lens technology onto our patients.

At Vance Thompson Vision, we are dedicated to providing the latest advancements and technologies in cataract surgery to our patients. We always strive to have a wide range of the most innovative lens and laser options available in order to choose the ideal technology for each patient. The PanOptix® lens, which more than 99% of the patient participants in the FDA clinical trials said they would choose again, is a wonderful lens option that can bring remarkable benefits to our patients.

Multifocal Lenses

Multifocal IOLs work within the eye to provide clear vision at more than one distance. They are commonly chosen by patients who have developed presbyopia along with or prior to their cataracts. 

Presbyopia is the age-related decline in near vision that occurs due to the natural hardening of the eye's lens, which limits its ability to change shape and focus properly. Nearly everyone will eventually develop presbyopia sometime between the ages of 40 – 50. 

Multifocal IOLs, such as those made by ReStor and Tecnis, are made with specialized materials, diffractive designs, and graduated, concentric circles that focus light at different distances according to the type and quality of the ambient light. In many cases, these lenses can dramatically reduce or even remove a patient's dependence on corrective lenses.



The FDA-approved Acrysof IQ ReSTOR IOL is an exciting, advanced artificial lens that can provide crisp and clear vision for near, intermediate, and far distances. For patients undergoing cataract surgery, choosing the Acrysof IQ ReSTOR IOL can significantly decrease and possibly eliminate the need for bifocals or reading glasses. 

Most people don't realize how often and consistently their eyes change focus to look at things at different distances. We tend to take it for granted until, as we age, we notice that our eyes' ability to automatically focus starts to weaken. The Acrysof IQ ReSTOR IOL utilizes specialized apodized diffractive and refractive technologies to create a range of focusing power and a decreased need for other prescription lenses. In addition, the Acrysof IQ ReSTOR IOL is an option for certain patients who aren't eligible for refractive vision correction surgery such as LASIK. Refractive Lens Exchange is an elective vision correction procedure for patients who do not have cataracts but choose to receive artificial intraocular lenses to obtain their best possible vision.


The FDA-approved Tecnis Multifocal IOL is an innovative implant solution for cataract surgery patients who enjoy active lifestyles. The Tecnis lens is designed with a series of concentric rings that span its entire surface. This ring technology is called lens diffraction and allows your eye to focus clearly on objects at different distances with smooth, natural-feeling transitions from object to object. Choosing a multifocal lens like the Tecnis is an exciting option for cataract surgery patients who would like to avoid or decrease their need for glasses or contacts after their procedure.

EDOF Lenses

Extended Depth of Focus (EDOF) lenses provide patients with very similar vision outcomes to multifocal lenses but through a different design. The Tecnis Symfony EDOF lens elongates the patient's range of focus and contrast sensitivity via its specialized front-surface and back-surface diffractive designs and achromatic technology. By providing an elongated depth of focus, the Tecnis Symfony IOL allows sharp vision and natural focus transitions for near, intermediate, and distant objects.

EDOF lenses are available as one of many innovative options for cataract surgery patients as well as those electing to undergo refractive lens exchange without cataracts. EDOF lenses provide most patients with vision that is much sharper than what they experienced before surgery; however, certain patients may still need magnifying glasses for very fine detail.



The vast majority of patients do very well after cataract and refractive lens exchange surgery; however, the period of adjustment to multifocal lenses varies from patient to patient. Some patients may experience halos and glare, especially in dark environments, but these issues usually improve over time. Further, even during the adjustment period and with some glare or halos, most patients still enjoy vision that is significantly improved to their vision prior to surgery.

If you are considering having cataract or refractive lens exchange surgery, it is very important that you find a provider that has a wide range of implant options to choose from. This will allow you and your surgeon to find the ideal option to match your unique needs. At Vance Thompson Vision, our wide selection of advanced lens implants can accommodate patients across the board to provide clear vision at any range. It is also important to seek out an eye surgery center that can fine-tune your vision after your surgery if desired. For example, we are able to use procedures like LASIK and other refractive surgery options to maximize your vision outcome following your lens implant procedure.

Our large menu of lens implant options, our ability to fine-tune your vision results after surgery, and our outstanding surgical team are what make Vance Thompson Vision your clear choice for cataract or refractive lens surgery.

It is also important to note that certain multifocal and accommodating lenses are considered elective due to their enhanced design and are typically not fully covered by insurance. They often carry an additional fee.

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Procedure Information

Recovery Time  
1 - 2 days
Procedure Time  
30 minutes (15 per eye)
Follow Up Time  
1 day, 1 week, 1 month
Recovery Location  
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See the Difference

For patients with advanced cataracts, surgery could become a necessary step in treatment. If you are living with or nearing the advanced stages of cataracts, reach out to Vance Thompson Vision in Billings, MT for a consultation about refractive cataract surgery. Board-certified ophthalmologist surgeon Dr. Russell Swan and his team have the skills and experience to help you become cataract-free.

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*Individual results are not guaranteed and may vary from person to person. Images may contain models.