Multifocal and Toric IOLs

Conventional vs Premium Cataract Surgery (See following page for more information about lens choices)

Multifocal, Extended Depth of Focus and Toric Lens Implants

Although there are several technologies available for use during cataract surgery, patient preference determines which intraocular lens (IOL) is used during cataract surgery. "Conventional" cataract surgery simply removes the clouded human lens and is replaced with a single focus IOL. This is the procedure of choice if the use of glasses for distance and near vision is preferred by the patient.

Optical error called astigmatism can be corrected by either a laser or astigmatism correction (toric) IOL. If reduced dependence on spectacles for distance vision is desired, attention must be paid to correct astigmatism. Small or large amounts of astigmatism can be corrected. The amount present will determine if a laser or an astigmatism correcting (toric) IOL is used. If spectacle independence for intermediate and near vision, either an Extended Depth of Focus (EDOF) or Multifocal I(DMF) OL can be selected. We prefer the Alcon Vivity and Alcon PanOptix IOL for this purpose.  Both the Vivity and PanOptix lenses are available as torics, correcting larger amounts of astigmatism simultaneously. We routinely use a femtosecond laser to contribute to the accuracy and safety of the procedure.

How do EDOF or DMF lenses compare to conventional monofocal lenses?

During clinical studies, Over 90% of patient’s found that they no longer needed their glasses after having EDOF or DMF lenses placed in both eyes, compared to spectacle independence in only 8% of patients with monofocal lenses.

 Clear Lens Extraction

New advances in cataract surgery and intraocular lens implants (the artificial lenses used to replace the human lens) have resulted in a new form of refractive surgery. Now, cataract surgery and clear lens extraction (CLE) can not only restore vision lost because of cataract formation, but also improve vision in individuals whose refractive error is too great for Laser Vision Correction.

 Other advantages include:

• Full range of vision. With this increase in vision quality, DMF patients are able to pass the visual acuity portion of the driver's license exam, in most states, unaided by glasses or contact lenses.

• The ability to read small type quickly and easily. While only one of 13 patients with any other IOL could read small type, four of five diffractive multifocal patients were able to read small type without reading glasses.

• Better vision in all lighting situations. Whether in brightly or dimly lit conditions the apodized diffractive optics of the DMF lens minimizes the occurrence and severity of visual disturbances compared to other multifocal technology

As with any surgical procedure, there are associated risks and benefits. While there may be a decrease in the need for glasses, some patients may occasionally notice rings around lights at night after receiving a multifocal IOL.  These side effects may make it more difficult to drive at night or perform tasks in low light conditions although most patients report the side effects diminish over time. While virtually everyone experiences an improvement in vision after cataract surgery, some people will have better uncorrected vision than others. Therefore, it is important to discuss the potential risks and benefits with your doctor who can guide you through this important choice.

As can be seen, the decision on which IOL to implant is a complicated one. For this reason we offer extensive counseling using video and graphic media to assist in explaining benefits and risks.