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Cataract Lens choice for Radiology
Hi I did a quick forum search but the last similar post was from 2011 and only had a couple replies.
I have a cataract in my dominant eye which needs to be removed. The options of lens type (monofocal versus multifocal) combined with choice of tailoring the lens for nearsightedness vs farsightedness seems a bit overwhelming and I was wondering if anybody who has had cataract surgery could post their choice and outcome.
Right now I need glasses (+1) for reading books and have a mild proscription for distance as well. I do not currently need glasses for radiology as the monitors seem to be in the sweet spot.
It seems going monofocal for distance and having to deal with reading glasses might be best overall (dont need to do the contralateral eye, less chance of visual artifacts, could enjoy outdoor activities and sports without glasses) but id like to avoid needing reading glasses for radiology and could see going monofocal set to near/intermediate and using glasses for distance being good as well.
Multifocals worry me because of the risk of halos etc in dark environment (radiology), but the increased range of vision is alluring.
thanks in advance!!
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5 Replies
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Monofocal with anti-UV tint with a refractive strength to match your healthy eye. If you have regular astigmatism, get a toric. Just wear readers like the rest of us mortals.
Has your ophtho said anything why you have unilateral cataract ? Any history of trauma ?
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Have had multifocal bilaterally for 9 years. No problem with halos with monitors. Do wear glasses due to astigmatism at work.
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How do multifocal lenses even work?
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Thanks for replies, my cataracts are bilateral, one is currently asymptomatic.
tartrate: multifocal lenses have concentric focal strengths which depend somewhat on the size of your pupil and neuroadaptation to allow the brain to focus at different focal lengths. accommodating lenses theoretically allow the ciliary muscles to somewhat change their shape. but these are all usually cash add-ons compared to monofocal lenses so conflict of interest in recommending them obviously exists. Also from what Ive read so far, there is some loss of contrast sensitivity and other issues compared with the standard monofocal lenses especially at intemediate distances (like reading radiology) but its unclear to me if and how this shows up in real world use.
[link=https://www.reviewofophthalmology.com/article/after-the-hype-which-presbyopic-iol]https://www.reviewofophth…e-which-presbyopic-iol[/link]
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Resurrecting a dormant thread. I feel that’s better than starting a new one, but apologies if not.
I found 3 useful threads from 2006, 2011 and 2018.
I was wondering if there have been any new developments with multifocal IOLs, or are monofocals still the prefered choice?
Is there a particular brand that’s considered superior?Any personal stories to share, to steer me towards monofocals vs multifocals?
I really liked this 2006 insightful post by fw, wondering if things have changed much since it was written 17 years ago:
[i]I went on the cataract surgeons equivalent of auntminnie (sorry, members only) and scrolled through some of the threads on the bifocal lenses. Here is a comment out of a post by Dick Mackool, one of the well known investigators in this field:[/i]
[i][i]Monocular results20/20 or better: 44% of eyes20/25 or better: 84% of eyes20/30 or better: 99% of eyesBinocular results20/20 or better: 82% of patients20/25 or better: 96% of patients20/30 or better: 100% of patientsKeep in mind that these are uncorrected results. If the patients were allowed to wear their best distance correction when reading binocularly, 90% were 20/20 or better and 100% were 20/25 or better. (Some patients have astigmatism and/or slight hyperopia that doesn’t bother them enough to have LRI or lasik).Also note the dramatic improvement with binocular vs monocular reading. This is definitely not surprising and, in my view, a strong argument against mixing and matching ReStor with other IOLs (I have no comment re mixing and matching ReZoom and Crystalens).[/i][/i]
[i]The funny thing is that on Saturday I joined my wife for a lunch with one of the other local cataract and refractive guys. And among other shop-talk they discussed the question what lens they would choose for themselves. And both opted for a monofocal acrylic lens….[/i]
[i]Anyone consenting you for a multifocal lens should be honest enough to tell you that a single digit percentage of these has to be explanted/replaced down the line while with the more proven lens designs IOL exchanges are in the promile range. Also, BCVA and contrast sensitivity (two issues I would consider important for a radiologist) are apparently still better with a perfectly measured set of monofocal IOLs.[/i]
Thanks for reading.
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