Multifocal IOL OR NOT for second eye

[vmk]

In 2012 I had cataract surgery on my left eye and a Tecnis ZMB00 multifocal IOL
was implanted. I experienced halos and floaters after implantation. I considered having the lens taken out. I was told that the halos would get better over time and when I had cataract surgery on my right eye and implant another multifocal IOL the brain adjusts and it would be better. It is now 2016 and I am still experiencing halos from lights. The halos can be in rings or one ring with bursts of lights. Now I do need cataract surgery on my right eye. My eye surgeon expressed that he thought a Tecnis ZKB00 multifocal IOL would be best and that the halo problem would not be as bad cause the new lens has less rings. I am not willing to take the chance. I would like to know how people do with a multifocal IOL in one eye and a monofocal IOL in the other?

[JohnHaganMD]

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[rwbil]

I had the TECNIS low add Multifocal 2.75 implanted in my left eye.  Based on my research I think it was and is current the best MF option available in the US.  In fact I was the 1st person that my Ophthalmologist implanted with that lens (Believe me it was my decision not his.  In fact all the Opthalmologist in my area do the Restor so I had to talk him into it.)  and based on my results and others it is now his lens of choice.

But yes I get halos at night.  I guess everyone is different but from what I read the Halos are relative in size to the IOL add power so the lower add is better.  

I can only tell you I am waiting for the Tecnis Symfony to get FDA approval before doing my other eye.  Based on those FDA results I might decide to implant the Symfony in the other eye, which is suppose to have the same rate of halos as a mono focal lens.  I will be talking to doctors that did both the Tennis low add and Tecnis Symfony trials before making a decision.

Right now my 2 eyes balance each other out so I can drive fine at night, but I do worry if I had 2 Tecnis MF 2.75 would the halos be a problem or maybe my brain would make it all work.

But I will say the Tecnis MF 2.75 is great for day time.  Close, intermediate and distance is all good.  

[SoftwareDeveloper]

The ZMB00 is a high add lens, and usually those have a bit of a drop off in intermediate vision.  I'm guessing you are in the US where the Symfony isn't available (you'd asked about it on another thread, suggesting your surgeon didn't mention it as an option), but another premium lens option that is available in the US with low risk of halos would be the Crystalens which might give you a bit more intermediate in that eye which might balance the drop off in intermediate from the multifocal.  

Since you need cataract surgery in your other eye it is likely too late to try contact lens monovision, since if you get a monofocal lens in the other eye you could either set it for distance or consider a slight bit of monovision to get more intermediate (or near depending on how much monovision and which distance is more important to you).

The studies show that the likelihood of halos is much lower in the new low add Tecnis multifocals  (which would also help with intermediate), but its understandable if you have problems now that you don't wish to risk more.

[JohnHaganMD]

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[JohnHaganMD]

A lot of people have the same experience you have and a lot have problem with multifocal on the first eye and rush into a second eye and they have problems in both eyes.

If you can read with your multifocal IOL then you might want to have the monofocal IOL set for distance 0.00  You might want also to back off and get a second opinion from a different surgeon since your first surgeon told you your symptoms would get better and they didn't and now seems to be pushing another multifocal IOL when you still have problems with the first one. Please read carefully this article http://www.medhelp.org/user_journals/show/1648102/Consider-ALL-the-Options-Before-Your-Cataract-Surgery-Working-Through-Whats-Best-For-You  ;

[vmk]

thank-you