What is a Multifocal Intraocular Lens?

Intra-ocular Lenses (IOL) for cataract surgery are small lenses made of a soft polymer (like Acrylic) and are implanted inside the eye in place of natural opaque lens. The advantage of IOL is a clear wide field of vision and less dependence on spectacles. The soft material of IOLs allows them to be folded and inserted through a small incision of 2.2mm during cataract surgery . They open up inside eye in lens capsular bag to give clear vision. Some IOLs are non folding made up of PMMA which are used in larger incision cataract surgeries or secondary implants in previously operated aphakic eyes.

What are different kind of intraocular lens?
  • Monofocal foldable IOLs - Correct majority of distance vision and patient has to wear near glasses as n when required
  • Toric foldable IOLs -
    - Correct astigmatism component in distance prescription of spectacles
    - Patient has to wear near glasses as n when required
  • Multifocal foldable IOLs - Corrects majority of distant and near vision correction , hence, reduces the dependence on spectaclesfor distance , intermediate and near vision but may give slight lower contrast, halos and glare specially in night driving.
What are the different Multifocal Lenses now available?

There are different types of Multifocal Lenses currently available:

  • Refractive Diffractive Multifocal IOL
  • Aspheric Diffractive TRIFOCAL IOL
  • Extended Depth of Focus -EDOF IOL
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What are the advantages and disadvantages of the diffractive / refractive Multifocal IOL?

Advantages: Many patients use this opportunity of Cataract Surgery to get rid of Spectacles. The decision to opt for Multifocal Lens has to be taken after doctor examines your eyes in details and decides that your Eyes are suitable for them. Also your lifestyle, reading and driving habits have to be taken into account while planning for these Multifocal /TRIFOCAL IOLs. Most of the patients are able to function at distant, intermediate and near vision without spectacles after surgery while some may need minor amount of spectacles.

Disadvantages:Few patients may still require spectacles occasionally after Surgery. Some patients note less contrast sensitivity, glare and haloes around lights at night which may interfere with your ability to drive comfortably at night. However, most patients find that they get used to this phenomenon with time and the glare and haloes become less obvious.

Is MONOVISION an alternative to Multifocal/Trifocal IOLs?

For people who are driving at night and do not want to take the risk of having glares/halos after multifocal IOLS monovision can be an option. We implant Monofocal IOLs in both eyes but choose a monofocal which leads to myopia ( minus spectacles power) in non dominant eye .The dominant eye is corrected for distance and the non dominant eye for near by deciding the powerofmonofocal IOL accordingly.

Will I need glasses after Cataract Surgery?

If you opt to receive a Monofocal Lens implanted in both eyes for distance vision, you will definitely need reading glasses after Surgery. If you receive a Multifocal /Trifocal Lens there is a good chance you wont need glasses. 85% of patients implanted with Multifocal did not need glasses after surgery for distance or near vision according to FDA trial. EDOF IOLs give spectacles free distance and intermediate vision but may need reading glasses for near work. The odds of becoming free of Spectacles are better if your Corneal astigmatism is low and your Eyes are otherwise healthy.

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Is a Multifocal Lens recommended for every patient?

No. It is recommended for most patients, but not for patients who have problems with their retina, glaucoma affecting central vision, Corneal astigmatism, Keratoconus, Corneal dystrophies or optic neuropathy. In addition, your doctor will discuss the advantages and disadvantages of a Multifocal Lens as it pertains to your individual lifestyle and expectations. Patients with unrealistic expectations may not be appropriate for Multifocal Lenses.

Will it take longer for my Eye to recover from Surgery?

Recovery from Cataract Surgery is the same whether you receive a Monofocal Lens or a Multifocal Lens. One can resume normal activities within few days. The brain must adjust, however, to the new optical system created with the Multifocal /Trifocal Lens (the way its takes time to get adjusted to new spectacles). This neural adaptation may take weeks to month and will allow better vision perception with time.

So how do I decide which IOL is best for my cataract surgery?

Your eye surgeon will be able to guide you on the choice of IOL depending on your lifestyle and eye condition after detailed discussion and examination. The cost of IOLs vary depending on the make and specifications.