Multifocal IOLs, incl. Tecnis; & ocular surface disease

I plan cataract extractions soon, one eye at a time.  I'm a practicing physician who uses electronic record with small font that canNOT be enlarged.   From research & ophthalmologist's suggestion (operates at hospital & makes no profit on any lens), I'm considering Tecnis multifocal.  I'm aware of all the multifocal, including Tecnis problems reported.  However, would appreciate ophthalmologists' comments on whether or not they are hearing (by posters here, in practice, or at meetings) as to results with the latest version of Tecnis lens.  I need intermediate vision (preferably without glasses) is important.  Also, having enough near vision to examine my own eye for occasional surface filaments, debris or stray eyelash, & to apply eye drops is important (see below)  is critical, even though I I don't mind glasses for near reading.

I have dry eyes and allergies, already on meds (Restasis, artificial tears, oral & eye antihistamines, prn Alrex).  My ophthalmologist's associate (sidewalk consult) said multifocals are ill-advised with ocular surface disease, though my personal ophthalmologist offered me the multifocal (Tecnis or ReStor); at another appointment soon I'll ask this, but would appreciate your insight.  Thank you.

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

There are a wealth of experiences posted here my scores of people about their experiences with monofocal and multifocal. In a study published two years ago by Dr. Kutryb and me in Survey of Ophthalmologist we found that people with multifocal IOLs were 23 times more likely to bring an eye problem post op here than monofocal IOLS.

I am a practicing ophthalmologist and have been using EHRs for 3 years. If I were having cataract surgery I would choose a monofocal aspheric IOL with mini-monofocal with near bias (perhaps shooting for -1.25 in dominant eye and -2.50 in non-dominant eye. I would feel that like now I would be able to read and use a computer without glasses. (like I do now). My distance vision would not be great but I'm use to that and I would plan to wear no line bifocals as I do now for distance vision and to see at near without removing the glasses.

Using the search feature and archives you can access all these discussions here on the eye forums. You can use PUBMED and search articles on the subject including the one's I've published.

There is no correct answer, it varies from person to person and they expectations, how they feel about glasses and their hobbies and jobs. I do know some physicians that have chosen multifocal IOLs for their own eye but more choose mono-focal.

JCH MD