Cataract IOL

Hi guys. I'm asking this question on behalf of my dad. He has developed cataracts in both eyes and is looking into the surgery options.

The local surgeon has presented him standard monofocal IOLs and the Acrysof Restor IOL. The surgeon has recommended the monofocal. I have looked around the web and found that there are other options in the multifocal department such as the AMO Rezoom and the AMO Technis multifocal. I will look around for the availability of these lenses.

My dad does some driving and also uses the computer. From what I have read the Rezoom seems like a better choice since it balances out between near and far vision. I could not find information about the Technis, though according to the website it provides all round excellent vision for all distances.

I have two questions. First, would a multifocal be far superior to the monofocal? I ask because the multifocal lens is quite a bit more expensive. Second, I have read that the Restor lens has now been improved. If so, what are the advantages/disadvantages between the Restor, ReZoom and Technis? User reports would be really useful.

Thanks in advance for all the help.

[John C Hagan III, MD, FACS, FAAO]

In my opinion given the early technology of multifocal IOLs the aspheric monofocal IOL is the superior IOL with much less expense and a much lower complication rate. Use the archives and search feature. This forum is full of hundreds and hundreds of people with problems with multifocal IOLs. Dr. Kutryb and I have done several studies on these forums and find that a multifocal is about 23 times more likely to generate a complaint on these eye forums than a monofocal.

If I were having cataract surgery I would have an aspheric tecnis IOL put in each eye.

JCH MD

[Shahmatt]

Thanks for the reply.

The surgeon offers the Acrysof IQ IOL monofocal. Is this inferior to the Aspheric Technis IOL monofocal you have mentioned?

With the aspheric lens, what range of vision can my dad reasonably expect? I suppose glasses for reading and computer use would be necessary, but how about night driving?

[John C Hagan III, MD, FACS, FAAO]

Yes that is a quality IOL by a great company. How well he see's will depend on the health of the rest of his eye (most important), second the success of the surgery. The IOL can be targeted for distance in which case many people only need glasses for shopping, computers and reading. Or a reading RX can be targeted in which case its just the opposite.

Monovision aspheric IOLs do not cause the night vision dysphotopsia of the multifocal IOLs.

JCH MD

[caren123]

Dear Dr. Hagan:
I did not know monovision RX coulod  provide a range that included "reading, computers and shopping."  My understanding was that they only worked well  for distance.  Would glassses be needed for TV viewing as well as driving?
Thank you.

[disappointed66]

I have the Tecnis Aspheric monofocal lens in both my eyes.(after having the horrible Restor explanted from my left eye)  They were set for distance.  The only time I need glasses is to read small print. I am typing this on the computer without glasses.  If you click on my user name you will be able to read some very informative and useful post.  Everyones eyes are different, but I strongly advise to stay away from multifocal lenses.  Save your money

[Shahmatt]

Thanks everyone for the information.

Ok so my dad has got a prescription for the Alcon SN60WF lens for the right eye.

My dad uses the computer and mobile phone a lot. So we asked the surgeon about trying to get "perfect reading and ordinary at distance", as opposed to the normal "perfect distance and ordinary at reading".

Unfortunately the surgeon claims that the distance vision would be -2.0, for an IOL corrected for perfect near vision.

He also seemed uncomfortable with doing this kind of procedure as he says that no customer has requested it before. A -2.0 vision at distance would probably require my dad to wear glasses at all times anyway, so we went with the prescription for "perfect distance and ordinary near".

The doc also talked about the possibility about have good distance on one eye and near on the other. What are the possible complications of this kind of procedure? If my dad can read a mobile phone without having to reach for the glasses then the problem is solved.

[John C Hagan III, MD, FACS, FAAO]

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[baggyrinkle]

Just like disappointed66, and several others here, I am 72 and have monofocal IOL's, both eyes set for distance and the same Alcon SN60WF lens you were prescribed. I only need glasses for close up reading. I can operate the computer digital camera, and my iPhone all without glasses. No problem. Setting both eyes for distance allows you to use cheap dime store reading glasses. Otherwise monovision could require prescription lenses for some activities. And your depth perception will be diminished with monovision.  Of course, everyone is different and my outcome may be related to having only slight astigmatism and no other major eye problems. Before, shopping was a night mare and I had a pile of reading glasses all over the place. Good luck and keep us posted. FYI both of my My alcons are 18.0D. Another factor contributing to a good outcome is accurate targeting of IOL power and your surgeons skill and experience. I suspect that a lot of people complaining about blurry vision is related to missing the mark when initial eye measurements are taken. Measure twice and cut once I always say.
Keep us posted please.