Author: Dr Val Phua MBBS, MMed (Ophth), FRCOphth, FAMS
Photo by: Dima Pechurin
Multifocal intraocular lenses seem to be the perfect answer for correcting vision after cataract surgery. Not only can it address the common refractive errors of short-sightedness, long-sightedness and astigmatism, it can also deal with presbyopia, restoring vision for both distance as well as near work. While the technology has made significant improvements over the years, these types of lenses are not for everyone. How do you know if it is the right lens for you?
Multifocal lenses prides itself on the convenience it brings to patients after cataract surgery, reducing dependence on reading glasses for near work. For a majority of patients, they represent the ideal solution to correcting vision and presbyopia (老花眼). For some others, they will find certain side effects like glare, halo and decreased contrast unbearable and want an exchange of the lens. The presence of glare and halos are more evident at night so patients who work more at night like driving a taxi during night shifts may want to bear this in mind when considering their options.
To increase the success of satisfaction with these premium lenses, patient selection has to be quite strict. Ideally, besides cataract, the eye should be otherwise healthy and free from disease. Meaning to say any issues with the cornea like scars and irregular astigmatism, retinal issues like swelling and bleeding, nerve problems like glaucoma and inflammation are all set ups for decreased success with these lenses.
These premium lenses are also quite sensitive to any decentration so any condition that could cause the lens to be out of its perfect alignment including weakness of the “strings” of the bag holding the lens or complications occurring during cataract surgery could also deter your eye surgeon from choosing these lenses.
Some patients may also have extremely high expectations of their vision after cataract surgery. Perfectly clear, sharp vision for distance, intermediate and near tasks with equally good vision at night and under dim conditions. This level of projected expectations also contribute to the dissatisfaction with the use of these premium lenses. While the technology behind these lenses are good, it is still at most a close runner up to what your natural lens could achieve before presbyopia set in. And while multifocal lenses do significantly decrease dependence on reading glasses, some patients may still feel more comfortable just sliding on a pair of reading glasses for prolonged periods of reading.
Success and satisfaction with multifocal lenses is high with the right patient selection and for many, it has been a life changing solution to meet their vision goals.