Multifocal/accomodating IOLs for monocular patients?

[Mayalu]

I am a one-eyed patient who needs cataract surgery and my doctor told me that the new multifocal/accomodating IOLS are only used in two-eyed patients. Is this true and if so will the technology ever evolve to where they can be used succesfully in monocular patients?

[Joan M Pernoud, MD]

From what I can tell, your doctor is giving you the best advice. A monofocal lens will give the best quality vision.

Your doctor might use a plano (neutral implant) instead of no implant, depending on the measurement of your eye to give you the best possible vision and to hold your vitreous back to minimize the risk of a retinal detachment......to keep your eye more anatomically correct.

[Mayalu]

After going back and reading some of the posts from people who have had the Restor and ReZoom lenses I don't think I would want then even if I had two eyes! I couldn't find any posts from one-eyed people like me like you mentioned but the posts I read sounded bad. I have never driven but since the cataract formed a big problem for me is walking at night because of the glare from streetlights and headlights, lighted bus shelters, etc. - sounds like this was a greater problem postop than preop fir a lot of patients - very sad...

I will mention both IOLs to Dr. Pamel this afternoon. I am severaly myopic(-19) and it is interesting that my first doc had said he might even put in an IOL with neutral/no power(?) - has anyone ever heard of this??? He said I would not need glasses for distance but I would need reading glasses.

[JodieJ]

I think that your best bet for a problem-free outcome would be an aspheric monofocal IOL.  The AcrySof IQ and the Tecnis both come in acrylic.  I was very pleased with my outcome with this type of IOL; I never experienced any problems.

[Mayalu]

You are right - at this point since I am at risk for RD from ROP and extreme myopia it really doesn't bother me that much if I need to wear reading glasses - it would be nice to not have to put in a contact lens every morning anymore for distance but I would pay even that price if it just meant I could have my clear, 20/30, pre-cataract vision back with no glare, blurriness, double vision or halos - I just want to see!!! I am just curious why my doc flat out said the 'premium' IOLs are for two-eyed patients only, thought maybe it had something to do with the technology.  I know that the doc I am going to see today specializes in phakic IOLs (Verisyse) for refraction in severely myopic patients so it will be interesting to see what he has to say.

[JodieJ]

I don't think that there's anything about the technology of the Crystalens (or the multifocals, for that matter) which requires two eyes.  (Some do say that a monofocal/multifocal combination is less than optimal.)  But I'd assume that a monocular patient would want the IOL which has the best chance of a good outcome (and have it implanted by the best surgeon in town).  There are some heartbreaking posts in the archives of this site from monocular patients who received "premium" IOLs.