Whilst monofocal lenses provide focus at one distance only, multifocal lenses allow for vision at a range of distances, meaning they can correct both near, intermediate and far distance. These are a more popular option for those who want to also eliminate their dependency for glasses.
Disadvantages of Multifocal Lenses
While multifocal lenses improve near, far, and intermediate vision, many people still have difficulty seeing up close. Although they can see the computer screen, their vision is blurry when trying to read a book. However, this can be corrected with reading glasses.
Which lens is right for me? That depends on your needs. If you're comfortable wearing glasses after cataract surgery, a monofocal lens may be the right choice. If you want to avoid wearing distance glasses after cataract surgery and have astigmatism, a toric lens might be appropriate.
Multifocal IOLs aren't for everyone. However, if you are a candidate for this surgery, the benefits generally outweigh the associated risks. Reduced lifetime cost of glasses and contacts. Multifocal IOLs can decrease your need for reading glasses or computer glasses after cataract surgery.
There is no question, if you want the best possible night vision, then a monofocal lens is your best option (Figure A), but you must be willing to use over-the-counter reading glasses.
Disadvantages of monofocal lenses:
If you take the option to improve your distance vision, you will still need to use glasses when reading. This also works in reverse – if you have chosen to improve your short sightedness, you may need to wear glasses for distance – for example when you are driving.
A monofocal lens implant will provide you with a crystal clear lens, that results in excellent vision for reading distant signs when driving, seeing a movie or watching a ballgame.
1: Comorbidities. If someone has an ocular comorbidity in either eye (eg, severe dry eye disease, irregular astigmatism, epiretinal membranes, macular degeneration), he or she is not eligible for a multifocal IOL. In my practice, this means that 50% of patients are ineligible.
Does Medicare cover multifocal lenses in cataract surgery? No. Medicare only covers a monofocal IOL. You can use glasses to make up the difference after surgery.
A monofocal or single-focus lens is designed to provide clear vision at a single distance point. This means you will be able to see objects far away, but will need glasses for reading and any type of close, detailed work.
Leading Lens Choice for Cataract Surgery: Trifocal IOLs
Alcon's Panoptix Trifocal Intraocular Lens provides clear vision at all three visual ranges: distance, middle and close-up. This represents a pretty astonishing technological advancement.
You will not harm your eyes by wearing your old glasses. However, you may prefer not wearing them since, in most cases, your vision will have improved after surgery, in particular your distance vision.
How long does recovery take? Your eye will feel normal again 24 hours after surgery. However, your sensitivity to light may persist for a few more days. It will take four to six weeks for your eye to fully heal.
If you wear monovision or multifocal contact lenses you may find that your distance vision, especially at dusk is compromised. You may need to consider wearing glasses for driving at night, or swapping to a pair of distance only contact lenses, to give you the best vision.
The eye, the brain and the calendar.
The majority of patients will adapt to multifocal IOLs within six to 12 months, according to Dr. Maloney. But about 10 percent of patients never will adapt.
Combining a monofocal with a multifocal IOL allows both of the patient's eyes to achieve excellent distance vision with the added benefit of some pseudoaccommodation in his multifocal eye.
For a multifocal lens, there are extra costs ranging from $1,500 to $4,000; however, costs can fall outside of those ranges as well.
Results: Multifocal IOLs were associated with a 0.71 QALY increase at an increased cost of $3,415 compared with monofocal IOLs, leading to an ICER of $4,805/QALY from the societal and health care sector perspectives.
Many, but not all, costs incurred for cataract surgery are covered by Australia's Medicare system. The Medicare safety net only applies to items that attract a Medicare benefit, and only to medical care provided in the clinic. The safety net does not apply to procedures formed in our day surgery centres.
Among the most common symptoms patients experience when wearing multifocal eyeglasses for the first time are headaches, nausea, dizziness and depth perception problems. You might feel a swim and sway effect, be uncomfortable using the stairs, and have a hard time focusing between intermediate and near distances.
Uncorrected distance visual acuity of 20/40 or better at 6 months was achieved by 92% of patients in the multifocal IOL group and 97% of patients in the monofocal IOL group.
However, it's not uncommon for things to appear fuzzy in the distance from time to time. This type of contact lens contains multiple prescriptions, and they use some of your distance vision to help with your nearby vision. That can make your vision blurry at a distance.
While many people will obtain 20/20 vision from their IOL, 30 to 50 percent of people who choose a monofocal IOL will still require corrective lenses after surgery. Schedule a consultation with an eye doctor near you to see if you qualify for surgery.
That means that if you and your surgeon choose cataract surgery with a MonoFocal lens, it's likely afterwords you'll have clear vision at a distance, but still need to use reading glasses for close up vision when you're reading, using a computer or doing other close tasks.
If the wrong IOL has been implanted, the experts noted that the options for correcting postoperative refractive error would be to exchange the IOL with the correct one, to add a second (piggy-back) lens, or to perform corneal refractive surgery.