Whats the differences between EDOF and mulitfocal
Posted , 8 users are following.
Hi l am 48 and told l need cataract surgery within a year and deciding what IOL to go with, l still have good vision both reading and disatance but l will soon lose this as my cataracts progress, l dont want to lose all my near / intermediate vision with monfocal distance so l am thinking of either EDOF or mulitfocal. IS the diffence that mulifocal gives you vision at near / imtermediate and disatance but EDOF only gives you intermediate and distance, so you need reading glasses but the overall constrast and vision quality is better and theres less side effects like night glare? is that correct? If thats the case then l prefer EDOF to multifocal, what the best brand of EDOF
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john20510
Posted
Thanks l spoke to two optomerists for advice, one said l should go with monofocal set for distance , the other one said l should go with Trifocal lens. You mentioned consider mono vision, l guess if l had both eyes set for distance l could wear a contract lens in one eye to give me close vision in that eye and its not permanet as l could just slip it out if l dont like it. One optomerist said if l go both set for distance l should be able to see well everyting past arm lenght well without glasses. Is that correct. Monofocal distance seems like the safest option as l am guaranteed clear sharp distance vision , only downside is glasses for close up, but withiut glasses would l have daily problems such as tripping over things not being able to see well enough to make meals on the table or read the car dashboard when driving. IF l go with Trifocal l risk poorer vision quality and contrast, theres no point being able to see near intermediate and distance if all three are poor quality vision . l find it hard to decide
RonAKA john20510
Posted
"You mentioned consider mono vision, l guess if l had both eyes set for distance l could wear a contract lens in one eye to give me close vision in that eye and its not permanet as l could just slip it out if l dont like it."
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Yes, you could do that. However if both eyes are set for distance you will have to live with that essentially for life, and to be glasses free you would have to wear a contact in one eye for life. Exchanging IOLs is not a simple risk free procedure. It makes much more sense to trial mini-monovision now by using contacts in both eyes. Then you can try different power easily to see what you like. The advantage of doing mini-monovision with the IOL lenses is that you can be essentially glasses free except for the occasional need for mild reading glasses. And keep in mind that most will still get progressive glasses which will correct both eyes for distance and close. With monovision you may hardly ever wear them, except for difficult situations like driving at night.
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On both eyes set for distance your optometrist has it right. You should see well from about arms length and further. Some may see closer. As I said with my distance IOL eye I can see down to 18-20" which is a little closer than arms length. For me the dash instruments are perfectly clear in my vehicles with my IOL eye. Making meals with both eyes set for distance is a bit iffy. It may be difficult to read recipes, or read the measuring cup, etc.
john20510
Edited
l am now thinking the best lens for me would be the TECNIS Eyhance . It does'nt have the contrast loss and side effects of the EDOF and mulitfocal but will give me better intermediate vision then standard monofocal with the same level of excellent distance, l dont mind glasses for reading now and then. Do you think thats correct
RonAKA john20510
Posted
From the information I have seen, the Eyhance may take you from about 3 feet close vision with a monofocal to 28 inches. So about 8" closer with the Eyhance. Is that going to be enough to use a computer monitor? Not sure. Not likely suitable for text on paper or reading a smart phone... I believe there is a thread here that users posted about it and can give you first hand experience with the lens. I think the Eyhance would only give good reading vision for text on paper, or a smart phone if it is under corrected in monovision style in the non dominant eye. Probably needs to be under corrected by -1.0 D or so. And if you do that there is probably no need to use an Eyhance in the dominant eye - just a monofocal.
john20510 RonAKA
Posted
Bit eyhance set for distance in both eyes would still give me a bit better intermediate vision then a standard monofocal , but if l were to go with an EDOF lens to get better intermediate what EDOF has the best contrast and vision quality and keast side effects
RonAKA john20510
Posted
Yes, having the Eyhance in both eyes provides a touch more binocular vision in the 28 to 36" range. The difference will not be huge and likely would not add a line of vision on the eye chart. I am not sure that this distance range vision is all that useful. The Eyhance to me without some significant myopia in the non dominant eye would fall short of my expectations for reading. I spend a lot of time on my computer with the TV on (yes bad habits!). I switch between reading text on my computer to looking at the TV (10 feet away) hundreds of times per day. I would not want to put on and take off readers hundreds of times per day. With my simulated monovision it has probably been a week or more since I put readers on. To me that is occasional use.
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I have a simplistic view of contrast and the probability of optical side effects like flare and halos at night. The basic aspheric monofocal lens has the lowest risk and as the range of closer vision increases the risk of loss of contrast and risk of flare and halos goes up. Of the more common Alcon and J&J IOLs on the market in North America I would rate them from lowest risk to highest as follows:
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Monfocal Aspheric (Tecnis 1, AcrySof IQ, Clareon)
Tecnis Eyhance
Alcon Vivity
Tecnis Symfony
Tecnis Symfony Plus (if it is available yet)
Alcon PanOptix
Tecnis Synergy
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If I was determine to have an EDOF and I was prepared for the night time halos and flare, I would likely go with the Symfony. I am not prepared for that however, and will go with either a Clareon or Vivity in my closer vision eye in monofocal under correction.
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These are tough decisions and everyone has different priorities and tolerance for optical side effects. I think the most important thing is to be fully prepared for what you are going to get, and not end up with buyers remorse.