Which intraocular lens (IOL) is right for you?
Welcome to Northern Beaches Cataract Retina Glaucoma.
Cataract surgery is performed every day by our team of expert cataract surgeons. Cataract surgery involves removing the natural lens, which has become cloudy, and replacing it with an artificial lens that is clear and transparent. This allows better transmission of light and in turn better vision.
Many people ask whether their new lens will wear out over time, and the answer is no. The lens should last for the rest of your life. The decision of which lens to insert needs to be made before cataract surgery. In most cases, we do not recommend changing the lens in the future.
The lenses we offer in this practice are the most up to-date available anywhere in the world. It’s helpful to understand that in our day-to-day lives, there are three common distances that we use for our vision. They are distance vision, intermediate vision, and near vision. Distance vision is anything further than 3 metres away.
This is used for driving, watching television, looking at a wall clock, or seeing people down the street. Intermediate vision is for anything between 60 cm and 1 m, like using a computer, looking at a car dashboard, or using a phone at arm’s length. Near vision is anything between 30 and 40 cm, like reading a newspaper, a book, small print on your phone, or supermarket packaging.
Now onto the lens choices.
There are two main types of lenses. The first is a single focus lens also called a monofocal lens. The second is a multifocal lens. Different patients choose different lenses based on their lifestyle and their eye health. A single focus lens has a smooth surface, and all the entering light is focused to a single point. These lenses provide the clearest vision with the least aberrations. The downside is they rarely give independence from glasses for all distances.
If the lens is chosen for distance vision, reading glasses are almost always needed.
Some people may also need glasses for intermediate vision. If you don’t mind wearing glasses, this is the safest and most predictable lens option. Sometimes one eye is set for far distance and the other eye is set for intermediate distance. The brain is quite comfortable with this and this is called blended vision or mini mono vision. This results in good distance and intermediate vision and often near vision too.
Reading glasses may still be needed for very fine print. This is one of the most popular options today.
The second main lens type is the multifocal lens. Its advantage is that it provides good distance, intermediate and near vision. These patients are usually glasses free after surgery. This is achieved by rings of different power within the intraocular lens which allows some of the light to be focused for each of these ranges of vision. The main disadvantage is that these rings can create optical aberration such as halos and starbursts. These are especially noticeable at night and can interfere with night driving. For some, these aberrations can be frustrating during the day as well.
Almost all people with multifocal lenses will experience some level of these aberrations. Usually, the brain adapts over time and the effects reduce. The majority of patients are happy with their results. Multifocal lenses are most popular in younger patients who are highly motivated to be glasses free. However, the eyes must be otherwise healthy without significant glaucoma or macular degeneration or dry eyes or squint.
There’s actually a third type of lens as well, a hybrid between the single focus and multifocal lenses. These are called extended depth of focus lenses or EDOF lenses. They have very small rings, usually small enough to avoid significant aberrations, but effective enough provide good distance intermediate and often near vision. Functionally, they sit between the single focus and the multifocal lenses and they’re also a very popular choice today.
So, what are people choosing?
Most people want to be relatively glasses free but don’t want too many aberrations. That means they typically choose either blended vision or an EDOF lens. A smaller number of patients are very motivated to avoid wearing glasses completely and are willing to accept some visual aberrations in exchange for that. They choose multifocal lenses.
So the main question we ask is how important is being glasses free to you?
Your surgeon will talk you through your visual priorities and the latest lens technology and help guide you to choose what is best for you. Our surgery is performed by a dedicated team of specialists, and we wish you all the best and hope this video has helped you decide which lens is right for you.