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Natural Lens Replacement



In some patients who have refractive errors outside the range treatable with LASIK, or that have cataract formation, removal of the natural lens of the eye and replacement with an intraocular lens (IOLs) may be helpful in reducing their dependence on glasses or contact lenses. This procedure is very similar to cataract surgery that is done for a cloudy lens. The accuracy in obtaining the desired improvement is quite high. In some patients, multifocal lenses may be helpful in improving distance and near vision. Some patients may opt for distance vision in both eyes or monovision.

Multifocal IOLs

Among the challenges of modern day cataract surgery, is making the best choice for each patient in order to meet individual needs or preferences in correcting both distance and near vision.

It is important for a patient to determine their particular visual needs and preferences. There are several choices that we have when we perform cataract surgery and place an implant in your eye.

  • Some choose to read without spectacles, which typically results in the need to wear spectacles for good intermediate and distance vision. These patients do well if we implant lenses in both eyes that leave the patient with about -2.00 Diopters of nearsightedness in both eyes.
  • Others choose mono-vision, which is correcting one eye for the distance, and the other eye for near vision.
  • Some patients choose to see sharp for distance and do not mind wearing optical aids for near tasks.
  • The fourth group emphasizes their desire for functional vision at both distance and near. To meet the needs of this group multifocal lens implants are required. The product of choice is the Array Multifocal IOL manufactured by Allergan. This is the only foldable multifocal approved by the FDA. Most patients are functional for many near and distance tasks without spectacle correction.

Advantages and Disadvantages of Monofocal IOLs versus Multifocal IOLs

For distance vision, the monofocal IOL provides the most clarity. The Array multifocal generally provides good distance vision, but in some patients it may not be quite as sharp as with a monofocal IOL. For near vision, the monofocal IOL generally does not provide good, crisp vision without glasses, if the patient has been fully corrected for distance. Intermediate vision is usually good with both types of lenses, although it may be somewhat better with the multifocal IOL. The multifocal IOL provides adequate near vision, although spectacle independence is not guaranteed.

Your visual needs/preferences can help determine which IOL is best.

 

Distance Vision

Intermediate Vision

Near Vision

Both Eyes Monofocal Distance

BEST

GOOD

Glasses necessary

Both Eyes Monofocal Near

Glasses necessary

GOOD

BEST

Both Eyes Monofocal (Monovision)

GOOD

GOOD

GOOD

Both Eyes Multifocal

GOOD

BEST

GOOD

GOOD = glasses may be necessary to provide you with the sharpest vision.

Approximately 41% of patients implanted with bilateral Array IOLs never need to wear eyeglasses, 50% wear glasses on a limited basis (such as driving at night or during prolonged reading), 12% always need to wear glasses for near work, and approximately 8% need to wear spectacles on a full-time basis for distance and near correction. There are 15% of patients that have difficulty with halos at night, and 11% have difficulty with glare, as compared to 6% and 1%, respectively, in patients using monofocal IOL's.

The decision to have a monofocal or multifocal IOL is best made prior to surgery on your first eye. Most patients do better if they have the same IOL in both eyes. Please ask your doctor if you have other questions concerning what is right for you.

For more information about multifocal IOLs, please call 1-800-Eye-To-Eye or respond via our website inquiry form.

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