Mini-Mono or Multi-focal. Which one is better?

I have Symfony EDoF. I would take the halos and starbursts all day and every day. Having said that, for me those are not the problem. The problem is the nighttime glare including possibly lens edge glare. You may not experience lens edge glare as you take glaucoma medication which constrict the pupils and limits the glare at night. Tolerance for halos and starbursts varies from individual to individual and it is difficult to predict who will be bothered by it.

Hi Jeff - soks is right in that no one can predict an outcome. Stats will indicate high percentage if satisfaction no matter what you choose however if you end up on the 5 to 10% that aren't happy stats mean nothing.

Everyone is different. Most people tolerate mini monovision well. I personally didn't go that route due to my migraines and didn't want any chance of a depth perception issue (but that is me). I did go with EDOF Symfony lenses and they worked out fine for me.

Since my surgeries have read some very positive reviews from this that targeted their monofocal lenses for intermediate distance and only wear glasses for distance. That setup works well for most usable vision. It really all depends on your personal preferences. Weigh that against not even multifocals will guarantee you glasses free. For dome glasses still needed for near vision.

One hopes for the best but in the end one adapts to what is following surgery.

If you want to base decision on stats monofocals provide best stats for night time halos and glare (although edge glare can still happen if you are going with a square edge IOL. But these also are better at preventing or delaying PCO. Round edge IOLs have less incidence of edge glare but do not prevent or delay PCO as well.

Every lens has a compromise so it's a matter of which trade-off you are willing to take.

If going for a mini monovision approach personally I would target dominant eye for plano or 0.25 nearer as the target is not always completely accurate. IOLs come in .50 increments of power and the healing process can alter it another .25. Better to be slightly near sighted than far sighted.

Wishing you the best.

hi, my experience with multifocal is that it must be exact, and make sure your surgeon does multifocal lenses primarily during surgeries. if you dr only does them once in a while find another dr who specializes in multifocal iols, and has an excellent history of exchanges. ive found out the hard way.

as for night driving and low light conditions. the glare or starbursts could be an issue currently, i have two different multifocals installe (not by choice right now---will be exchanging in the spring) the recent exchange has 12 concentric rings, which cut down on what i used to see big starbursts coming from overhead street lighta and headlights. the other eye which will be exchanged has 9 concentric rings and has helped tremendously with glare, although im only seeing 20/40 with this lens and was installed a year ago. so for me, im happy with seeing the rings at night instead of the bursts that would give me extreme difficulty in wet roads and head on traffic( which is my town) .

low light conditions just suck things get fuzzy, not to the point of blindness, but just enough out of focus to drive me a little nutty. i use the light from my phone to help with that. another thing my surgeon reminded me of, was pupil dilation women tend to have larger pupils, but shorter arms...so im wondering if some brand iol were built for a mans eye.

my overall suggestion is research and visit with a few surgeons before you jump into multifocals. im in south florida, originally chose a dr closest to me in key west and it was a big mistake. i needed to exchange those lenses and chose to go to sight trust ( sister company to my previous lasik surgery) in sawgrass fl @3 hrs away. its an all day event for a follow up apointment but worth it when you have a dr/surgeon who knows what he is doing when it comes to multifocal lenses

I had my mono focal lens set for distance and had the second IOL set -0.5D in for slightly better near vision for mini mono vision. I almost never wear reading glasses. I had to retrain my brain to hold things further away from my eyes (rather than 5", I now hold my phone around 12"). With regards to driving, I don't think you will have a problem at all with those settings. I see 20/20 or 20/25 in one eye (depending on the day) and at worst 20/40 in the other eye. My understanding from the driver test in California is you need 20/40 in one eye and 20/70 in the second / worse eye though it might vary in different states. With that said, I wouldn't recommend someone drive with that kind of vision without glasses. I had my surgery done almost 2 years ago when I was 55 and in my bad eye it's now 20/40 due to a secondary cataract (which explains the bad vision). We are going to wait a while longer per my doctor's recommendation, but if the vision gets worse or more hazy then he can do a quick in office laser on that eye to fix the secondary cataract.

The reason I mention this is because I don't know if one would have more potential problems with YAG laser treatment for a secondary cataract with a multi focal (especially if they already have a prior condition such as astigmatism and/or glacoma). I've read as many as 70% will develop a secondary cataract within 5 years. It's a quick and simple treatment but as with anything there can be complications and I don't know if risks increase with a multi focal. Perhaps others can chime in on that.

Either way, I'm glad I went with a mono focal set for distance and the second one -0.5D for mini mono vision. Ironically, my left eye was set for -0.5D and sees better at all ranges. But, I think it's best to keep the mini mono vision as close as possible should you choose that route so that your eyes work together.

I have no glares, no halos, no problems whatsoever with driving at night. Everything looks clear and I see well at all ranges - although I will admit up close vision much less than 12" will look a little blurred. I can either wear reading glasses or if I just need to quickly read a medicine bottle and I don't want to get a pair of glasses, I can just turn on the LED light on my iphone. For whatever reason, it's always easier to read small fine print in good lighting. I can also pull out the credit card magnifier I have between my iphone and the silicon flimsy protective case but it's rare that I need to do that.

I agree with your doctor's recommendation to go with a mono focal lens given that you have glacoma and other conditions. My vision was also somewhat compromised and my doctor also was against a multi focal. I work on the computer a lot, so I'm glad I went with distance and mini mono vision. I never need glasses when I work on the computer or when I drive. If I read books and magazines 24/7, then I probably would have had my vision with a mono focal lens set more to intermediate for the first eye and then if I still had a little trouble reading I would have set the second eye a little further in but if I had no trouble I might have set it a little further out (for better distance). Good luck to you.

Did your surgeon give you a recommendation on what type of multifocal he/she would suggest in your case? You are doing the right thing with all the research in advance. They often oversell these lenses.

There are going to be a tradeoffs going with a multifocal vs monofocals (set the same) vs mini-monovision. I went with a Restor 2.5D (a low-add, fixed multifocal). I had also considered Symfony but ultimately went with the Restor due to the large concentric ring artifact that are part of the Symfony design plus my surgeon's familiarity with the different lens options.

It was a good choice for me. I do have a "gap" in the mid range of my vision (4 ft to 10 ft) where that eye isn't as clear as my non-surgery eye (the second eye has a mild cataract). However, distance vision is fantastic and the nighttime halos are very small and not bothersome at all. I have "serviceable" computer/reading vision and rarely wear glasses anymore but that is partly due to the great vision in this range via a multifocal contact in my second eye. I think with two identical Restor's I would need reading glasses sometimes.

When it comes time to do eye #2, I would prefer an EDOF design to a pure multifocal to gain the added range of vision. When I mentioned the "gap" with the Restor, I should mention that it is ONLY noticeable if I close my other eye and just rely on the eye with the IOL. With both eyes open, vision is really fantastic from about 20" to infinity and both eyes are working together without any issue.