Accommodating vs multifocal/tri lenses for younger person
Posted , 5 users are following.
Hello all. I have been trying to do a lot of research on the different lenses but it is hard finding how younger people are doing with the lenses vs the older people whos eyes may react differently to the more premium lenses. I am 30yrs old. Ended up with fast developing cataracts in both eyes. Had PRK/Lasik in late 2017. No cataracts present. A couple months ago my vision at a distance started getting blurry. Like I was always in a haze. Then within 2 weeks the vision in my left eye went from a little blurry at a distance to full on mature cataracts where everything is extremely blurry and I can just barely make out shapes up close. My right eye is slowly following the same signs the left had. I had a cataracts evaluation exam last week and was not happy with how it went. None of the machines could get light pass my lens for accurate measurements besides with a CT scan. The surgeon seemed very unsure of his abilities outside of a normal cataracts situation and heavily pushed the mono lens due to no accurate measurements. When I asked if he could just request all my exam information I had for my PRK surgery several years back, he did not want to and just wanted to go his route. Which I found extremely odd and so did my eye doctor who referred me to him. I scheduled another exam for a 2nd opinion from the surgeon who did my PRK and it isn't until Feb 12th. With high hopes of surgery by Feb 20th. My main thing is I want to stay away from glasses and contacts as much as possible. I paid around $5500 2yrs ago to not have to wear either... And I do a lot of driving and computer use. As well as plenty of use on my phone. I am wondering if the accommodating lens option would be best over the tri lenses since it relies on your eye muscles to flex the lens for adjustments and my eyes are still young and should handle that fine. The tri lenses my eye doctor said people have complained that it's like watching a baseball game through a chain link fence. You can see the game fine, but it seems like something is there in the way in the middle at all times. And if a bird lands on the fence, you see that clearly, but now the game is slightly blurred. And none of the 3 distances is really clear, just "good". Iv also wondered about 2 different types of accommodating lenses like 1 that is for distance and mid range and the other for distance and near. If that would be small enough to not notice anything negative vs the 2 different mono lenses one for distance and one for near... Any thoughts? Sorry for the Hello all. I have been trying to do a lot of research on the different lenses but it is hard finding how younger people are doing with the lenses vs the older people whos eyes may react differently to the more premium lenses. I am 30yrs old. Ended up with fast developing cataracts in both eyes. Had PRK/Lasik in late 2017. No cataracts present. A couple months ago my vision at a distance started getting blurry. Like I was always in a haze. Then within 2 weeks the vision in my left eye went from a little blurry at a distance to full on mature cataracts where everything is extremely blurry and I can just barely make out shapes up close. My right eye is slowly following the same signs the left had. I had a cataracts evaluation exam last week and was not happy with how it went. None of the machines could get light pass my lens for accurate measurements besides with a CT scan. The surgeon seemed very unsure of his abilities outside of a normal cataracts situation and heavily pushed the mono lens due to no accurate measurements. When I asked if he could just request all my exam information I had for my PRK surgery several years back, he did not want to and just wanted to go his route. Which I found extremely odd and so did my eye doctor who referred me to him. I scheduled another exam for a 2nd opinion from the surgeon who did my PRK and it isn't until Feb 12th. With high hopes of surgery by Feb 20th. My main thing is I want to stay away from glasses and contacts as much as possible. I paid around $5500 2yrs ago to not have to wear either... And I do a lot of driving and computer use. As well as plenty of use on my phone. I am wondering if the accommodating lens option would be best over the tri lenses since it relies on your eye muscles to flex the lens for adjustments and my eyes are still young and should handle that fine. The tri lenses my eye doctor said people have complained that it's like watching a baseball game through a chain link fence. You can see the game fine, but it seems like something is there in the way in the middle at all times. And if a bird lands on the fence, you see that clearly, but now the game is slightly blurred. And none of the 3 distances is really clear, just "good". Iv also wondered about 2 different types of accommodating lenses like 1 that is for distance and mid range and the other for distance and near. If that would be small enough to not notice anything negative vs the 2 different mono lenses one for distance and one for near... Any thoughts? Sorry for the long post, it's just been a real shock and scare for me within the past month. Thank you. long post, it's just been a real shock and scare for me within the past month. Thank you.
0 likes, 5 replies
Guest Sephent
Posted
Hi
I understand it must come as a big chock to have cataracts in such a young age.
I had surgery 6 month ago age 45, but my story is a little bit different, because I was born with cataracts, so I have had poor vision all my life.
Like you I did not want to give up accommodation, so I lived with it. But last year my vision was under 50% and accommodation would in any case start to decline due to age, so I had no reason to not go for a surgery.
Everyone have doubt when it comes to choosing lenses, it is a really hard choice to make. And some of us, me included, also have a period after surgery with doubts, we always think of what might could have been.
Reality is, that theoretical perfect is never achieved, good thing is most people get really good results, that are far sufficient, when we stop thinking what if.
In my case, like yours, there was no one that had been able to make measurements on my eyes, or take pictures of the retinas.
But the clinic I ended up choosing, did not give up that easily. When it was not possible in the first place, they gave me some extra hardcore pupil dilating drops, and then they were able to get some measurements in the edge around the cataracts. Some of their measurements were off, so they made a lot of measurements, and then they sorted it, and used the numbers to make a decision.
I have ended up +0.75 both eyes with the new lenses, which is far from perfect, but very usable.
I have followed the evolution of lenses most my life, I am old enough to remember when the first iols came to Denmark, before that there were only really big heavy glasses...
Accommodating iols - sorry to, and it is off course my personal opinion, they don´t work, stay away!
They work poorly even in young eyes, and the tissue in the eye often lock these lenses, so they stop being accommodating. And when some years have past, and you most likely have had Yag treatment because of pco (pco is 99,99% certain at some point, given your age) replacing of the iol will be high risk.
Accommodating iols - don´t do it!
I have a mix of lenses with edof one eye and trifocal one eye.
Edof is not a bad lens, it does give more vision range than a monofocal, but the trifocal is just better, in my opinion, at least if you have healthy eyes.
The mix works fine for me, if I should choose only one type lens, it would no doubt be the trifocal of these two.
The edof have more visual side effects as well.
And you will have side effects no matter what premium lens you choose. Don´t believe any of the statements that only some get side effects, everyone gets some side effects with premium lenses.
Monofocals can have some side effects as well, but they will always be a safer choice.
I can not in any way recognize what your doctor is saying about trifocals. I have fluid vision from far to about 18". If my lens had not shot over target it would be even closer.
And I can see closer than that as well, but details are getting harder to see, even that it does not feels blurry, a bit hard to explain.
But most people are happy with the vision they get from trifocals, and most of the people that are not happy with trifocals is because they can´t get used to the visual side effects.
The only lenses I sometimes think I maybe should have chosen instead, would be the Oculentis lenses, that does not have the ring design like other premium lenses, I would recommend you to take a look at these as well.
Monofocals with minimonovison can work really well, if you have two healthy eyes beside the cataracts.
I know a young guy close to 30 years, he had cataracs surgery when he was 3 years old. He have monofocals, and are free of glasses most of the time. He can read and do most daily activities without glasses, he only use glasses for reading extensive time or seeing really small stuff.
And many other people are not depended on glasses for many daily tasks with monovision, so if you end up with having monofocals as your only option, it might be better than you think.
I know your situation is a hard pill to swallow, I hope my story can help you just a little bit.
Sephent Guest
Posted
Thank you for your honest input. Definitely a lot of factors to work out pros and cons of each lens.. I am going to try to get an actual list of the exact lens options the place I am going to on the 12th has so that I can more accurately compare what my options will actually be. So I don't end up wasting time looking into a lens they don't even provide (on the site they just list the type of lens options they have, not the actual names). Your opinion on the accommodating lens is really insightful and I never thought about that, but makes perfect sense. Your relying on your eyes to act a certain way after surgery and if they don't do exactly what they need to do, the whole purpose of that lens is shot. I'll keep this updated with any new info I get before and after my exam. Thanks again for your help.
chen78740 Sephent
Posted
I have PRK surgery before cataract developed too. All the surgeons I have seen are not recommending premium lenses saying PRK causes the IOL power measurement more difficult and much worse side effects than natural eyes. I will use mono-vision with monofocals.
gmag21 Sephent
Posted
I'm also 30 years old. Had cataract surgery on my non-dominant left eye when I was 17 and implanted a rezoom multifocal IOL (which is no longer on the market). If i could do it over again i would go with monofocals. I'm considering exchanging my multifocal for a monofocal now due to the debilitating side effects but it's very risky surgery because i had the YAG laser capsulotomy for PCO.
A few years ago the doctors discovered a small cataract in my right eye. In the past year it has developed quite significantly & causing night time issues with glare (compounding the other issues from my multifocal eye). im actually thinking i will put a monofocal in my dominant right eye.... try it out & compare to multifocal... and use that knowledge to decide if i want to risk swapping out my multifocal for a monofocal (given the high risks)
Chris53317 Sephent
Posted
Sephent, If the surgeon cannot get a good reading of your eyes with the IOL Master then any target prescription will be a best estimate and could be the wrong prescription, which will mean that you will need glasses. If that is the case I would select monofocal IOLs with both eyes adjusted for distance. Then you can get progressive glasses for full time wearing. This will give you the best options for distance and reading.
A point of clarification. There are many types of lenses but they fall into two basic categories. Standard or basic spherical lenses, and aspheric lenses (also known as premium lenses). Premium lenses are superior to basic lenses, and do not have any more side effects than basic lens. But they do cost more. There are premium monofocal, premium toric monofocal, premium trifocal, etc.