Aspheric monofocal IOL vs. "standard" monofocal

[southern_new_england]

Aspheric monofocal IOL vs. "standard" monofocal

I am a 67 year old male and have never worn glasses for distance, but I have developed cataracts in both eyes. My left eye is 20/40, but my right eye has become technically blind. I want to regain my good night driving vision and expressed concern to my eye doctor/surgeon over the halos and ghosting that I read about in these forms and elsewhere. So my doctor ruled out mutifocals and scheduled me to have Crystalens®  implants one month apart. When I questioned the need to do my still "good" left eye so quickly, he said that both eyes needed to be done for the Crystalens to function properly. He then said that Crystalens had some negative side effects, as well, and said I would be happier with monofocal IOLs set for distance, (I would use glasses for closer work, as I have already been doing for years). He said my right eye has so little astigmatism that it would not benefit from an Alcon ACRYSOF® Toric lens and that a "standard" IOL (covered by Medicare) would suffice. (When I decide to have my left eye done, I should get the Toric to correct its more severe astigmatism.)

I see aspheric monofocal IOLs recommended here by Dr. Hagan and others. I called Alcon and was told that their aspheric (and blue light filtering) ACRYSOF® IQ lens is the "new standard" in monofocal IOLs, although they are more expensive.

I am surprised that my doctor never mentioned the word "aspheric" to me. Is there ANY reason for me not to chose an aspheric IOL over a "traditional" monofocal IOL for my right eye? Would there be any problem having an aspheric monofocal in one eye and a subsequent  Toric monofocal in the other?

BTW, should an aspheric monofocal IOL be significantly more expensive than an "old style" (term used by the Alcon representative) monofocal IOL?

Thanks for any insight.

[JodieJ]

There is an excellent patient education video concerning the benefits of aspheric IOLs at www tecnisiol com.  The video promotes Tecnis lenses, but the same benefits apply to asperic Acrysof toric and IQ lenses.

[Ray T Oyakawa, MD]

The Alcon Toric is now a aspheric iol and is based on the SN60wf which is also an aspheric IOL. It is covered by Medicare.  It is an NTIOL and Medicare pay extra for the aspheric IOL.  I am sure your doctor was going to use the aspheric.  There is no extra charge to the patient.

Aspheric optic play  more significant role as you pupil dilates.  You need to know your pupil diameter in a night time condition.  If it does not dilate to more than 5 mm or so,  there is little benefit with an aspheric IOL.  An aspheric Crystalens will be out soon.

Dr. O.