Cataract Surgery Multifocal Lens Pros And Cons | Eduardo Besser, MD (2024)

Following a lens replacement procedure such as cataract surgery or refractive lens exchange (RLE), patients will have a variety of replacement lenses to select from.

No single intra-ocular lens is best for everyone. These can determine a patient's choice, such as price and preference for a specific type of vision correction.

In recent years multifocal lenses have become a popular lens replacement option. Multifocal lenses offer many advantages for patients wishing to enjoy clearer vision following RLE or cataract surgery.

As with any optical procedure, patients should be aware of the pros and cons of multifocal lenses to make an informed choice.

Cataract surgery is the most common lens replacement surgery. Cataracts occur when the natural lens in our eye becomes hard and cloudy, making it difficult for light to enter. The lack of light leads to dim and blurry vision.

During cataract surgery, an eye doctor replaces a patient's cloudy lens with an intraocular lens implant (IOL). Depending on the lens, this can potentially allow patients to see clearly at a variety of distances without glasses or contact lenses.

Monofocal lenses are the standard lenses for cataract surgery. They are called monofocal because they correct the patient's vision to a single focal distance.

Patients can choose a monofocal lens that corrects for the following vision ranges:

Far distances: Best for activities such as reading street signs, watching television, and playing sports.

Intermediate distances: Best for activities such as viewing the car dashboard, using a computer, or playing board games.

Near distances: Best for activities such as reading, filling out forms, and knitting.

All monofocal lenses are of similar quality. A patient's choice will be determined by the single type of vision they wish to correct. Many patients who elect this type of lens choose to see clearly for distance activities, though they will always need glasses for intermediate and near tasks.

Monofocals are the standard lens for cataract surgery, but they are not the only type of lens on the market. There are a variety of lens implants patients can choose from.

Multifocal lenses offer a more advanced replacement option. Unlike monofocal lenses, which only correct one type of vision, multifocal lenses allow patients to enjoy clearer vision from a wider range of distances.

With certain multifocal lenses, patients will be able to see objects from near, intermediate, and far distances. For patients with astigmatism, specialty "toric lenses" are available to help with this condition.

Multifocal lenses are considered a safe and effective way for many patients to enjoy better vision at multiple distances without the need for glasses or contact lenses.

Multifocal lenses may not be best for everyone. Following a procedure like cataract surgery, patients will have to consider multifocal lens pros and cons to make their decision.

• Clear vision at all distances: Standard monofocal lenses only correct for a single type of vision (near, intermediate, or far) and will require glasses for certain tasks. Multifocal lenses give patients clear vision from multiple distances. This means, depending on their choice of lens, patients will be able to see close, intermediate, and far objects clearly without the aid of glasses or contact lenses.

• Freedom from glasses and contacts: Because patients can now see clearly at all distances they may no longer need reading or regular glasses.

This has several advantages. Patients can save money on repair costs and enjoy the comfort and convenience of seeing, reading, and partaking in activities without the hassle of glasses or contact lenses.

Additionally, many patients appreciate the peace of mind of not worrying about losing their glasses or protective eyewear when on vacation or after enjoying activities like swimming.

• Permanent improvements: Because the artificial lenses do not change over time, clear vision at all distances is permanent after receiving multifocal lens replacements.

• Safe and effective procedure: Cataract surgery and multifocal lens implants are considered fast and safe surgical procedures with rapid recovery and healing periods.

More flexibility with sunglasses: Patients can buy over-the-counter sunglasses without a prescription. This allows them to enjoy a wider range of styles that are less expensive than prescription sunglasses.

• More expensive: The most notable disadvantage of multifocal lenses is their cost. Insurance companies cover the cost of monofocal lenses for cataract surgery,

Multifocal lenses are not covered by insurance plans. Patients will have an out-of-pocket expense in order to upgrade to these specialty lenses.

However, there are flexible payment plans available for those who cannot cover the cost upfront. At our office, we have low and zero-interest payment plans available.

• May cause some glare or halo effect at night: In the dark, some patients may experience glare or halos surrounding lights. However, these symptoms are usually well tolerated by patients who quickly adapt to their new vision.
  

• Light adjustments: Patients may need more light for reading in dimly lit situations, such as going to restaurants or reading in bed.
  

• May still require reading glasses: Even with the aid of multifocal lenses some patients may require the occasional use of reading glasses for very small print or when reading with dim lighting.
  

• Not all patients qualify: Some patients are not good candidates for Multifocal IOLs due to ocular pathologies or diseases. These include macular degeneration and glaucoma.

No single lens is the right choice for every patient. They will have to weigh multifocal lenses’ pros and cons. Some things to consider before choosing between monofocal and multifocal lenses are:

• The desired range of vision.
  

• The presence of ocular diseases such as macular degeneration and glaucoma.
  

• Preference for lenses that can correct astigmatism.
  

• The cost and affordability of each procedure given their financial circ*mstances.
  

It is best to discuss these options and your desired goals with your ophthalmologist in order to make the best decision and customize the procedure based on your needs.