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Mono vs multifocal lens for cateract surgery

My wife is 41 yrs old. she had lasix surgery approx 10 yrs ago. She has developed a cateract in her left eye. What would the best option for her surgery the mono or multifocal lens?  The doctor seemed to lean towards the multifocal due to her age.
6 Responses
233488 tn?1310696703
MEDICAL PROFESSIONAL
Different strokes for different folks. You will need to use the archives and search feature to read about the pros/cons of each type of IOL. If I were having cataract surgery on myself I would NOT chose a multifocal IOl

JCH MD
Avatar universal
"The doctor seemed to lean towards the multifocal due to her age"  Would you believe the car salesman who sugested the Hummer because of it's great gas mileage?  Do your own research.  When it comes to most Opthamologists and IOL's, It's all about the sales job.
233488 tn?1310696703
MEDICAL PROFESSIONAL
I disagree. There are over 3 million cataract operations with IOLs in the USA this  year and as the baby boomers age that will rise to over 4 million. A need for cataract IOL surgery is the leading cause of reversible blindness in the world. Cataract/IOL surgery is the most successful and lowest complication major operation done on adults. The operation sells itself in the USA and the rest of the world.

The problem is when people expect perfection every time. It's a major operation and carries the risk of blindness. A perfect operation will not make an imperfect eye see normal (age macular degeneration, glaucoma, diabetic retinopathy, etc.) Plus glasses are usually needed for some or most things.

JCH MD
Avatar universal
I think maybe OldNavy meant that the multifocals are more expensive (beyond insurance)  than the monos and that some docs may try to sell you on the more expensive lenses, which I think is what my first surgeon did with me and the Crystalens.  I didn't buy it though.  In any case, you will want to learn the difference between multifocal and accomodating (Crystalens) lenses also.  

I had 2 cataract surgeries last year and got the standard monofocal ASPHERIC lenses.  I considered that Crystalens (accomodating ... extra expensive--$2500 per eye) but because my eyes were very far sighted, was told I would have to wear glasses in addition anyway. Plus I felt they were not totally "debugged" yet after reading what folks wrote here and elsewhere.  

I read too many complaints about the multifocal IOLs so didn't even consider them.

I have a different lens in each eye now--the B&L Sofport AO in one and the Acrysof IQ in the other.  I like the Acrysoft IQ better (just done 17 days ago).  I believe I have better contrast sensitivity with that one, especially in low light, but both are very good and I have better vision than I ever have had in the past with both eyes.  I will continue to wear the multifocal progressive eye glasses with my new IOLs for good vision at all focal lengths.

I have worn glasses all my life so it doesn't bother me to wear them but, if your wife doesn't want to wear glasses, she would have to consider the multifocal or accomodating IOLs.

Good luck with your research!
233488 tn?1310696703
MEDICAL PROFESSIONAL
=
Avatar universal
Hi,
I fell prey to lens-touts because of my relative youth and good health. Multifocal lenses offer vastly inferior vision to monofocal aspherics, the only slight advantage being better close up vision at the sacrifice of quality and acuity in the rest of the visual field, and absolutely dreadful night vision.  I found them so intolerable I had a bi-lateral explant of the hideous Restor for two monofocals, and find the vision both day and night beautifully clear and natural, but with the need for glasses to extended arms length - within that zone I can certainly see, but there is some blur and I cannot read ordinary print unaided.  This is pretty common for middle age, and relatively easy to adapt to, unlike the unnatural and distorted multifocal visual system.  

Be aware that there are $$$ in touting the so-called "premium" multifocal lenses and younger patients often get the ruthless hard-sell on the grounds that they will "neuroadapt".  Some patients have awful trouble with these devices, and are discarded like fishheads once the money is in.  Do a search on this forum, and check my own posts for all the problems associated with this inferior technology.  Yes I'm very biased, and would recommend the monofocals without reservation.  At least they will not send your wife almost insane as they did to me!  Don't be afraid to get more professional opinions and beware of anyone who "talks down" the excellent monos - your wife's wellbeing may not be their first priority!

Wishing you the best firefyt, eye issues are so confusing and worrying as there is a lot of commercial propoganda in this field, and frequently not a lot of ethics - as OldNavy966 has also suggested.

Regards, Restornomore
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