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Dr. PG
Dr. PG, Ophthalmologist
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Experience:  MBBS, MD (Ophthalomology)
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Opthalmologist question. I have just been diagnosed with cataract

Customer Question

Opthalmologist question. I have just been diagnosed with cataracts both eyes by an opthalmologist in my area. I am 67 in good health and my eyes are, other than the cataracts, in great shape. Everything else seems to be working well. I am far sighted and have worn glasses pretty much full time since I was 5 or 6. Have been looking on the web a lot and talking to others and have found an amazing and confusing plethora of available IOLs. It would be just the most wonderful thing for me to be able to see without glasses. My insurance will pay for a monofocal IOL. Have been reading about multifocal and accommodating IOLs. Even considering going to Thailand to have the surgery done. What seems to be the best mono lens out there as well as the best multi focal and accommidating? Am particularly interested in crystalens from eyeonics/ now Bosch lomb I think. What do you think? Experience? I am gathering as much info as I can right now. I just want to do this once and I'd like to get it right. Thanks, Ron
Submitted: 4 years ago.
Category: Eye
Expert:  Dr. Dan B. replied 4 years ago.

Many people have very good results and are quite happy with a monofocal IOL that allows them to see without glasses in the distance. Granted, most of these people need glasses to see up close, however, unless they make one eye their distance eye and one eye their near eye.

 

As you've mentioned, the other alternative is the presbyopia-correcting IOLs. They are becoming more and more mainstream and the crystalens does seem to provide some of the best results as far as patient satisfaction with spectacle independence. However, the choice of lens needs to be individually tailored to you and what your visual tasks are that are important to you. This should be a frank discussion you have with your surgeon about what lens would work the best for you, because they all work a bit differently and some would work better for your needs than others.

 

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My opinion is solely informative and does not constitute a formal medical opinion or recommendation. For a formal medical opinion and/or recommendation you must see an eye doctor.

Customer: replied 4 years ago.

Dr Dan,

I did not get the type of info that I specifically asked for. Seems to me that when I ask an opthalmologist for a specific answer that could stand statictical verification there is reluctance. I expect you to know a very lot more than I can get off the web in many places. Opthalmologists must have affiliations or at least preferences for products they are aware of and experienced with. Sometimes seems sort of like asking a Ford dealer what would be a good brand of car to buy. My situation is peculiar to me, but generally can be represented by stastics regarding other customers' satisfaction.

I need to see great at a distance. What IOL seems to consistantly accomplish this? I would love to see intermediate and close. I do not want to risk haloing or bluring. I work with gemstones and hobby with the night sky. Which IOLs seem to consistantly accomplish full range seamless vision? Is there less risk with mono IOLs? Ron

Expert:  Dr. PG replied 4 years ago.

Hi,

The outcome of your surgery not only depends on the IOL implanted in your eye but also on the fact that how clear are your corneas, what is the curvature of the cornea after surgery and how healthy is your optic nerve. Given the fact that you had good vision previously indicates that the optic nerve, corneas in your case must be healthy.

The results with monofocal and mutifocal IOL's are good. The patient satisfaction depends on the expectation of the patient. If one wants to do just routine work with not much reading then a monofocal IOL is good. But if a patient is into lots of reading then they usually feel happy after a multifocal IOL or a crystalens.

Your demand is both for near and far vision. Gemstones require lot of close work and night sky watching also needs very precise vision.

Frankly, in my experience it would be difficult to reach absolute clear vision for far and near without glasses.

One option in your case can be to attain good far vision with one eye and good near vision with the other, as suggested by Dr DanB. The other possibility is that you can go ahead with multifocal or crystalens and get good vision correction for either far or near, one of the cases and if required use a minor correction for the other filed.

In case of multifocals there are two good lenses Restore (Alcon) and Technis multifocal (AMO). Both show equally good results but patients adapt faster to Restore and haloes etc are less with this.

Crystalens is an excellent IOL with very good post operative results. It is a relatively new IOL with fewer studies.

As far as monofocal IOL is concerns the IQ IOL (Alcon) has an anti-glare coating to prevent sun glare. The other Technis IOL (AMO) is also good. The third one is Akreos from BAush and Lomb. For monofocal IOLs all three IOLs show excellent results.

Regards

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Dr. PG
Dr. PG
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MBBS, MD (Ophthalomology)