stats on outcomes of multifocal and monofocal IOL

Posted , 4 users are following.

where can I find some data on the likelihood of side effects of different IOL to help me make my mind if to go for mono or multifocal ?

just told by optometrist is time for cataract surgery, as glasses won't give me driving sight

I am shortsighted (-10), with astigmatism (-2), need verifocals (add +3) for reading and screens

lazy left eye

thank you for any pointers and replies

0 likes, 10 replies

10 Replies

  • Edited

    Monofocals have one main drawback. A correction power is normally used to correct your distance vision fully. At some closer point you will need reading glasses to focus close up. It is very similar to almost all older people where "their arms get too short" to read. This is easily corrected with progressive glasses or just off the shelf reading glasses. Some choose to correct to a closer distance. For example you could correct to leave you at +3. You would have reading, but would need glasses for distance. In this case progressives are a good option for correction.

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    Multifocal IOLs try to address this by allowing you to see both close and far. I don't know the statistics but they have a much higher probability of unwanted side effects. The main complaints are halos around light at night, and/or flare. Some do not get sufficient close vision to read comfortably. I would suggest these lenses are mainly for those that really want to be eyeglass free and are willing to put up with these issues.

    • Posted

      needing glasses for near for me would be better than risking issues with multifocal

      the question is how big are those risks

      if more recent multifocal make that risk much smaller, I would go for that instead

    • Edited

      The more popular multifocal lens in North America are the Alcon PanOptix, Tecnis Symphony, and recently the Tecnis Synergy. You should do a search here for comments about them. Some love them, and many hate them.

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      One thing to keep in mind with the monofocal and progressive glasses option is that your vision will be largely corrected with the IOL. The eyeglasses will not have to be anywhere near the -10 D that you have now. This allows the lenses to be much thinner/lighter and high index glass is unnecessary.

  • Edited

    If you're someone who cares about details, then you should go with monofocal.

    Do you do fine work like threading needles, carving, or drawing intricate art, and you need your vision to be as clear as possible? If so, then I would highly suggest avoiding multifocal. The multifocal gives you some flexibility so you don't need glasses all the time. Monofocal comes with less flexibility, but it will give you vision with the highest quality.

    If you have a "care-free" personality (meaning, you're okay with imperfections), and you move around a lot and rarely sitting in the same place for prolonged periods, then you might be a good candidate for multifocal. You could get away with not having your glasses with you all the time, and if you got the monofocal, be prepared to carry glasses with you at all times.

    Are you active at night or dark places? If so, also consider avoiding multifocal.

    • Posted

      thanks for the tips, it was I was looking for. is this work or personal experience of both?

      I do a lot of computer work and fair amount of reading, although for my older age I would like to do much less of that and be outdoor more

      I don't mind using glasses.

      With monofocal I will see well in the distance and less near, the opposite of what I had for most of my life.

    • Edited

      Personal experience. I'm not a medical professional if that's what you mean by "work" experience. I'm 26, and I wasn't wearing any glasses before. One day I just woke up with cataracts, so it was a huge change for me to adapt.

      If you don't mind wearing glasses, then PERSONALLY I would go with the monofocal. With the multifocal, you will still likely find situations where you have to wear glasses. It's only if you really, really hate glasses, then I would recommend the multifocal.

      Good luck to you.

  • Edited

    With monofocal I will see well in the distance and less near, the opposite of what I had for most of my life.

    You also have the option of getting near-distance monofocals and using glasses for distance. It's less common, but has worked very well for me and for others who do a lot of close/intermediate work and spend less time driving, outdoors, etc. As my ophthalmologist told me, "It's what your brain has been used to all these years, so I think you'll be happier with the outcome," and he was right.

  • Edited

    How is your vision with the lazy eye. Is it correctable with lenses? If so, then there is another option called mono-vision. That is when you correct the dominant eye with a monofocal lens for distance, and under correct the non dominant eye by about -1.25 to -1.5 D to allow some reading ability. It is not going to give perfect vision, but for many it allows them to go eyeglasses free. It just uses standard monofocal lenses so there is no premium for the lenses. And, for the distance they are set for, there are no side effects like there can be with a multifocal. Ideally one should try it with contact lenses first to see if you can accept the difference in correction between the two eyes.

    • Posted

      lazy left corrects ok.

      I have read about mono-vision and how brain sorts the eye difference, it seems a strange approach and I worry about the perception of depth, which I think would affect hand-ball coordination (tennis, volleyball)

      could easily try an older disposable left contact lens, which is what I do if I run out of the new ones

      thank you

    • Edited

      If you have a recent (last year?) prescription, then places like Costco will give you 5 or so contacts to try for free. I currently have one monofocal IOL set for distance that lets me see down to a little less than 2 feet quite well. In the other eye which has a mild cataract but I can still see pretty good, I am using a contact that under corrects by about 1.25 D. I tried a few contacts and decided less than 1.25 D was not enough to be able to read well, and more than 1.5 D was too much. However, that is only my opinion. If considering monovision one should try the different under corrections with contacts to see what YOU like.

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      If doing monovision the usual practice is to do the IOL in the dominant eye first with the power set for distance. Then no less than 6 weeks later do the second eye. That gives you time to make the final decision as to whether or not you go for monovision. That six weeks is a good time to confirm the under correction you want.

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      One last thing to think about is that IOL's come in increments of 0.5 D, not 0.25 D like contacts or glasses. So it is improbable that you will get a perfect correction with the IOL, and you should ask for a range of 0.25 D of correction, an not expect it to be right on. You always want to be slightly under corrected rather than over corrected. Over correction reduces your close vision unnecessarily.

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