Over 18 million people choose to restore their vision and undergo cataract surgery every year. Cataract surgery is a straightforward outpatient procedure that removes the clouded natural lens in your eye and replaces it with an artificial lens called an intraocular lens (IOL).

Multifocal IOL vs. Monofocal IOL: What You Need to Know

When selecting a lens, there are two general types of lenses to choose from: multifocal or monofocal lenses. Both will treat your cataract and reestablish your vision, but there are a few key differences.

A multifocal IOL is designed to correct both cataracts and presbyopia. Presbyopia is a common age-related condition. Beginning around the age of 40, the natural lens inside the eye begins to harden and becomes less flexible. This reduces the eye’s ability to switch focus from near to far to in between and back again, resulting in vision loss and, in most cases, the need for reading glasses or bifocals.

A multifocal lens has several different focus regions that are designed to allow you to see clearly up close, far away and in between, and, in most cases, will eliminate your need for glasses. After surgery, you may experience an adjustment period during which you may see rings around lights at night. This is normal, and as the eye adjusts to the lens over time, the visual impression of these rings typically lessens or goes away.

In contrast, a monofocal lens has only one focus region. It allows you to see objects far away, but you will continue to need glasses for reading and other up-close activities.

Monofocal IOL vs. Multifocal IOL

Monofocal IOLs provide good distance vision, but you will continue to need reading glasses to see up close.

Multifocal IOLs are designed to provide you with improved near, intermediate and distance vision and reduce or eliminate your need for reading glasses.

Talk to your doctor about all the benefits of a multifocal IOL and if the TECNIS® Multifocal IOL is the right choice for your lifestyle.

Important Safety Information - TECNIS® Multifocal Intraocular Lens (IOL)

Indication: TECNIS® Multifocal intraocular lenses are indicated for primary implantation for the visual correction of aphakia in adult patients with and without presbyopia in whom a cataractous lens has been removed by phacoemulsification and who desire near, intermediate and distance vision with increased spectacle independence. The intraocular lenses are intended to be placed in the capsular bag.

Risks: As with many things, there may be a trade-off. If you decide to have a multifocal lens, your use of glasses may decrease, but at the cost of losing some of the sharpness of your vision. Even with glasses, this loss of sharpness may become worse under poor-visibility conditions such as dim lighting or fog. There may also be some visual side effects, such as halos and glare from lights at night, which are more common than with a monofocal IOL. Halos are rings of light that you may notice when looking directly at a source of light, such as oncoming car headlights. Glare is a scattered light effect that can appear around a source of light.

General risks with cataract surgery and IOL implantation: Whatever your lens choice, there are risks and possible complications of cataract surgery and lens implantation. Complications could be minor or temporary, or could permanently affect your vision. Complications are rare and may include the worsening of your vision, bleeding or infection. Contact your eye doctor right away if you have any of the following symptoms after surgery: itching, pain, flashing lights, “floaters,” a “curtain” in your vision, redness, severe headache, nausea/vomiting, sensitivity to light or watery eye.

PLEASE NOTE: Warnings and precautions accompany all IOLs because they are prescription-only medical devices. The following warnings and precautions apply to all multifocal IOLs.

Warnings: A very small number of patients (less than 1% in US clinical studies) may be dissatisfied and request removal of their multifocal IOL. Under poor-visibility conditions, your vision may be reduced more than it would be with a monofocal IOL. Under these conditions, you may have more difficulty recognizing some traffic signs and hard-to-see objects on the road. Therefore, you may need to take extra care when driving, especially in poor-light conditions. In rare instances, multifocal IOLs may make some types of retinal surgery more difficult.

Precautions: If your eye is not healthy (including glaucoma), your vision may not be good even after your cataract is removed. In this case, you may not get the full benefit of the multifocal IOL. Before surgery, your eye doctor will check to see if you have any eye diseases. Be sure to tell your eye doctor if you have any health conditions that may affect your surgery or vision, and provide an updated list of medications to the doctor. There is a chance that your vision with a multifocal IOL may not be good enough to perform very near or detailed “up close” work without glasses. The TECNIS® Multifocal IOL is designed for near vision at approximately 13 inches. Take all prescribed medicines and apply eye drops as instructed. You should avoid any activity that could harm your eye while you are recovering from surgery. Before and after the surgery, your eye doctor will tell you about activity restrictions. If you wear contact lenses, your eye doctor may ask you to discontinue wearing your lenses prior to being evaluated for the multifocal IOL. There were no patients 21 years old or younger included in the clinical study. As a result, there is insufficient data to support safety and effectiveness of this IOL in this age group.

Adverse events: The most frequently reported adverse event that occurred during the clinical trial of the TECNIS® Multifocal lens was macular edema, which occurred at a rate of 2.6%. Other reported reactions, occurring in 0.3%–1.2% of patients, were inflammation of the eye and secondary surgical intervention (including biometry error, retinal repair, iris prolapse/wound repair, trabeculectomy, lens repositioning and patient dissatisfaction).

REFERENCE:

1. Market Scope. The 2011 Comprehensive Report on the Global Presbyopia Correcting Surgery Market. St. Louis, MO: Market Scope LLC.