1. Community
  2. Eyes
  3. Cataract

Cataract multifocal lenses?

Posted , 7 users are following.

federico91976
federico91976

(just moved this message from eye problems to cataracts)

Last year I've went through cataract surgery for my left eye. They put a monofocal lens, which I don't like at all. I decided not to operate the right eye because although it has a small cataract, I like being able to focus on things.

I am pondering whether to pay for a private operation in both eyes and get multifocal lenses and was wondering if anyone with experience could help me decide. It's a lot of money but I would like to have good sight again. I am 49 yo. What would you advise?

And another question: I have presbyopia. Would that go away with multifocal lenses?

Thank you!

Federico

0 likes, 10 replies

10 Replies

  • RonAKA
    RonAKA federico91976

    Edited

    It would be very helpful to understand better where you are currently at for vision. Do you have a current eyeglass prescription for each eye that you could share?

    .

    Edit: In checking your previous posts I see this was your prescription 14 months ago or so.

    .

    Right eye:

    Sph: Distance 0.00, near 1.50;

    Cyl: -1.00

    Axis: 105

    .

    Left eye (the one operated):

    Sph: Distance +0.75, near 2.25

    Cyl: -0.50

    Axis: 100

    .

    Has that changed? If not, I see a couple of options:

    .

    1. You could consider getting another monofocal in your right eye, but instead of for distance, target it to leave you at -1.50 D myopic. You could simulate that now by using a contact in your right eye that is; Sphere +1.50 D, Cylinder -1.0 D. This would correct the astigmatism and leave you at -1.50 D. You could evaluate that to see if it would give you the near vision that you are missing. If it works then all you would need is another monofocal (and possibly a toric) in your right eye. This would likely be a zero cost option which could be done under NHS, if you don't need a toric lens. It looks like a non toric was used in your left eye and -0.50 D cylinder is quite acceptable.
    2. Your could get a multifocal in your right eye. On this side of the pond the most common choice seems to be the PanOptix. There are issues with them and it is hard to predict whether you will like it or not, and there is no real good way to simulate it. Looking at the positive side it may give you both distance vision and near vision in your right eye, and may be enough to go eyeglasses free while leaving the left eye as is. And, if you really like the way it works you could go back and do an exchange for another PanOptix in your left eye. Doing an exchange however is more complicated as they need to chop up the monofocal that is now in there, remove it, and insert the new lens. That also can have complications, but it is done. Could be expensive...
    • federico91976
      federico91976 RonAKA

      Posted

      Thank you so much, Ron, that's super helpful.

      My prescription is more or less the same, although my far sight with the left eye (the operated one) has got worse. My right eye, with the cataract evolving, went for a phase of improved far sight but now it has worsened again (back to original with a bit worse near sight). I am not sure what's the prescription right now but I more or less manage with the same glasses. I have plenty: for reading, for computer, for far sight (right eye)...

      Good to know that replacing a lens can be complicated (and expensive), I didn't know that. That's bad news, though. I would just love to have my good old vision. When I paint for some time, a couple hours, then my sight is horrible, even with glasses. I guess I strain my eyes...

    • RonAKA
      RonAKA federico91976

      Posted

      I would try the contact lens for your right eye that I suggested. It may be an interim solution until you are ready to do the second eye. If your left eye is good enough (20/25 or even 20/30) then a contact in the right eye may give you good enough near vision to go eyeglasses free. For sure you will learn something from the trial.

    • RonAKA
      RonAKA federico91976

      Posted

      On a quick check at a UK website called LondonOC, it looks like a single eye MF lens is in the order of £10,000, and probably more for an exchange in the eye that has a monofocal IOL now. They also show a Lenstec MF lens as an option. That is a brand I would not consider. PanOptix Clareon may be available, which would be a better choice in my opinion.

    • federico91976
      federico91976 RonAKA

      Posted

      Thank you so much again, Ron.

      The prescription of my right eye is changing a bit over time as the small cataract progresses, but I still prefer it to the monofocal left eye. Could I simulate the contact lens in the right eye with some pharmacy glasses by removing the left eye glass? Just to get an idea of how it works and how would I feel with a contact lens or with the right eye operated. I've never tried contact lenses, and if at work I want to see well with both eyes (computer work), then I would need to either remove the contact lens and use my current glasses or buy some new glasses. That's why I wonder whether some glasses could work for this test.

      I don't know why but my ophtalmologist didn't like the idea of getting different lenses for each eye, he said it was better to have both eyes on the same place ("balanced", he said). I convinced him to at least err on the near sight for the right eye (as he err on the far sight for the left one). Then I decided to cancel the whole thing.

      Is the astigmatism in the right eye caused by the cataract? Before all this ordeal started three years ago I had superb sight both near and far (in case this informs on the origin of the astigmatism)

      I was planning to get this done in Span, my home country although I live in UK. There it seems you can get multifocal for about 2000 euros / eye. But I will just try the plan you suggested. Thank you, thank you.

    • RonAKA
      RonAKA federico91976

      Posted

      Yes, I think you could do a simulation with reading glasses. The spherical equivalent of your right eye is -0.50 D (0.00 sphere plus 50% of cylinder). If you were to buy some +1.00 D over the counter readers and remove the lens for the left eye, that would be a rough simulation of what you could do with an IOL set for near. It would not be perfect as it would be better to fully correct the cylinder and then go for -1.50 sphere, but it would be worth trying for a minimal cost.

      .

      Part of your astigmatism in your right eye could be caused by the cataract. To know for sure you would need to see the prediction of what you could get with a monofocal IOL. If they did a full measurement of this eye, your surgeon will have this information, and you could ask to see it. The specific question to ask would be "What would the cylinder be if a non toric IOL was implanted?" Not sure about the UK, but at least in Canada and the US you have the legal right to this information as courts have decided medical information belongs to the patient, not the doctor. They can be difficult about it if they choose to, and require notice and to be refunded for the cost of producing it (click of the mouse and a sheet of paper!).

      .

      Are you saying Spain is your home country? If so, it could be good as the UK prices seem very high. In Canada a PanOptix multifocal is about $2,100 CDN. Much less than £10,000. If you are considering it, keep in mind there are lots of different multifocal lenses and some are not so good and in general they are higher risk.

    • john43646
      john43646 federico91976

      Edited

      I was planning to get this done in Span, my home country although I live in UK. There it seems you can get multifocal for about 2000 euros / eye.

      I recently had two Panoptix implanted at a clinic in North Yorkshire $6200.00 completed. No need for glasses at all now, near, intermediate and distance are all glasses free.

  • trilemma
    trilemma federico91976

    Edited

    I really don't know about multifocal lenses. I had considered Panoptix in my near eye for a while, but I am probably not going to go that route.

    My prescription is more or less the same, although my far sight with the left eye (the operated one) has got worse.

    How about numbers from a refraction (eyeglass prescription) done a month or more after the surgery? That can best tell you where you stand. Post sph and cyl.

  • soks
    soks federico91976

    Posted

    i am 48. i have panoptix. it gives the full range. i like them. i need mild glasses at night. (-0.75 cylinder)

  • federico91976
    federico91976

    Posted

    Thank you all for your replies!

    Trilemma, John very kindly found my prescription post-surgery in an old message:

    Right eye:

    Sph: Distance 0.00, near 1.50;

    Cyl: -1.00

    Axis: 105

    .

    Left eye (the one operated):

    Sph: Distance +0.75, near 2.25

    Cyl: -0.50

    Axis: 100

Back to top

Report or request deletion

Thanks for your help!

We want the community to be a useful resource for our users but it is important to remember that the community are not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in respect of any healthcare matters. Always speak to your doctor before acting and in cases of emergency seek appropriate medical assistance immediately. Use of the community is subject to our Terms of Use and Privacy Policy and steps will be taken to remove posts identified as being in breach of those terms.