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Multifocal vs Monofocal

Multifocal Monofocal
Corrects vision for far, near, and intermediate Provides good vision at one distance (typically far vision)
Minimizes or eliminates glasses Requires reading glasses after surgery
Partial coverage by Medicare or other insurance Covered by Medicare or private insurance

WHAT IS A CATARACT?

The eye focuses images through a lens inside the eye — like a camera uses a lens to focus. When we are born, the lens is clear and flexible, allowing crisp vision with a full range of focus from near to far. As we age, the lens becomes cloudy and inflexible, causing our vision to blur and increasing our dependence on glasses to refocus from far to near.

A cloudy lens is called a cataract. Because of the clouded lens or cataract, images may become blurry with age. Cataracts may make it progressively more difficult to read, drive, watch TV, and perform normal daily activities, and may blur vision in general. Cataract formation is a normal, unavoidable part of the aging process.

HOW DO I KNOW IF I HAVE A CATARACT?

If you are over the age of 50, you have and are developing cataracts as a normal part of the aging process. Though uncommon, some individuals develop cataracts as children or young adults.

Common symptoms of cataracts include:

  1. Blurry vision
  2. Difficulty seeing while driving at night
  3. Inability to see the TV clearly
  4. Difficulty reading or discerning fine details
  5. Glare around lights at night
  6. Cloudy, foggy, fuzzy, filmy vision
  7. Problems seeing colors clearly
  8. Loss of vision in low-contrast situations such as early morning or evening
  9. Light sensitivity
  10. Double vision

In order to determine if you have a cataract and if it is visually significant, an eye examination by an ophthalmologist is necessary. If the cataract is mild then surgery is not needed. Quite often an updated pair of eyeglasses will help optimize your vision. However, if your vision remains blurred in spite of wearing properly prescribed glasses then the next step will be to consider cataract surgery.

Traditional cataract surgery with a fixed-focus lens gives good vision at one of three zones. During traditional cataract surgery your doctor removes your cataract, and in its place a fixed-focus lens implant is used to correct your vision. With traditional lens implants do not correct astigmatism. If a patient has astigmatism, which means that the front part of the eye is shaped more like a football rather than round like a ping pong ball, then the patient would most likely end up in bifocals after surgery for best corrected vision. Bifocals are not necessary for everyone, however reading glasses will be necessary.The strength of reading glasses necessary can vary from patient to patient. These glasses can be purchased over the counter and range from a +1.00 to a +3.00. To find which strength is best for you we recommend that you sample the reading glasses in the store. A general rule of thumb to remember is that the higher power you pick the closer the print will need to be held to your face. Individuals with traditional cataract surgery are typically covered by your medical insurance. You would just pay your co-payment or deductible.

Cataract Surgery with the Astigmatism correction (TORIC LENS)

We also offer cataract surgery for patients that have large amounts of astigmatism who want to see clearly far away without glasses but don’t mind using glasses to enable them to see up close. In this type of cataract surgery, the initial steps of the procedure are done just like described above, but we pair this procedure with surgery to reduce or eliminate your astigmatism by using an astigmatism-correcting lens implant. With the eye set to see normally far away and the astigmatism corrected most patients see very clearly far away without glasses but need reading glasses to see clearly up close. Astigmatism-correcting lenses reduce or eliminate astigmatic focusing issues in addition to correcting your far away vision. Most individuals with an astigmatism reducing lens will see quite well without glasses far away. Most astigmatism-correcting lens implants do not allow an adjustable range of focus. Therefore, though your vision will be clear far away without glasses, you would require glasses to see up close (near) and at the computer (mid-range) after cataract surgery.

HOW DOES THE ASTIGMATISM-CORRECTING (TORIC LENS) IOL WORK?

The Astigmatism-correcting IOL is designed to correct for the natural existing astigmatism in the cornea. It is similar to the function of an astigmatism-correcting toric contact lens in that the astigmatism-correcting IOL neutralizes or compensates for the astigmatism in the cornea. So when you see through the astigmatism-correcting lens, your focus is sharp and clear without glasses for driving, watching TV or seeing objects far away. Individuals with the astigmatism-correcting IOL will need bifocal or reading glasses to see up-close (e.g., computer or reading vision).

HOW WELL DOES THE ASTIGMATISM-CORRECTING IOL WORK?

Approximately 95% of individuals with this lens see sharp and clear without glasses for driving or watching TV. On the other hand, individuals with a traditional IOL who have pre-existing astigmatism will have about a 25% chance of seeing sharp and clear without glasses for driving or watching TV. Specifically, the traditional IOL patients see great with bifocals or glasses for far away vision. But without their glasses, vision far away will be blurred by any residual astigmatism. On the other hand, individuals with the astigmatism-correcting IOL are much less dependent on glasses for their far away vision because the lens implant corrects the natural astigmatism for that individual.

Cataract Surgery with Multifocal correction

Premium cataract surgery is designed to enable you to see both far and near with minimal or no dependence on glasses. Premium cataract surgery involves astigmatism correction as well as the use of advanced-technology lens implants designed to provide clear vision over a broader range of distances than traditional lens implants. Multifocal lenses such as the Tecnis symfony multifocal will provide excellent vision for up close reading and mobile phone use, as well as intermediate and far vision for driving or watching TV. Occasionally patients may need to wear over-the-counter reading glasses for optimal computer distance vision.

WHAT IS THE Tecnis SYMFONY MULTIFOCAL LENS?

The Tecnis Symfony Multifocal Intraocular Lens (IOL) is the most recent innovation in lens implant technology. The Tecnis Symfony Multifocal lens is implanted in the eye as a lens replacement at the time of cataract surgery or refractive lens exchange. The best candidate is the cataract surgery patient who is 45 or older and dependent on glasses and/or contacts to see near, far and in-between.

WHEN IS IT USED?

The Tecnis symfony multifocal IOL is used in adult patients with and without presbyopia, who desire near, intermediate and distance vision with increased independence from glasses following cataract or lens replacement surgery.

Anyone who has a normal eye exam and is dependent on reading glasses or bifocals may be a candidate. Although Tecnis symfony multifocal lenses are a breakthrough technology initially approved for cataract patients with or without presbyopia, it is not necessary to need cataract surgery to qualify for the Tecnis symfony multifocal lens, just a desire to reduce or eliminate your dependence on glasses.

WHAT WILL THE Tecnis SYMFONY MULTIFOCAL LENS ACCOMPLISH?

The Tecnis symfony multifocal IOL has been shown in a clinical study to provide good near, intermediate and distance vision with increased independence from glasses in patients who have undergone cataract surgery. Patients with the Tecnis symfony multifocal lens in both eyes have a 90% chance of not needing glasses for any activity.

WHEN THE MULTIFOCAL MAY NOT BE USED.

There are no known contraindications. However, based on past experience the following types of patients possibly should not have the Tecnis symfony multifocal lens implant:

  • Individuals that are hypercritical with unrealistic expectations
  • Individuals with excessive complaints about their prescription
  • Individuals who drive at night for a living or whose occupation or hobbies depend on good night vision
  • Individuals who are amateur or commercial airline pilots
  • Individuals who have life-long complaints about glare
  • Individuals who are happy wearing glasses
  • Individuals who want guarantees on surgical outcomes
  • Individuals who have had previous Radial Keratotomy (RK) surgery
  • Individuals with pre-existing retina conditions such as macular degeneration

CLINICAL RESULTS

The FDA-approved Tecnis symfony multifocal lens is a breakthrough in intraocular lens technology for most people with cataracts (with or without presbyopia), that may restore more youthful vision. Results from a controlled clinical study of the Tecnis symfony multifocal IOL revealed that maximum visual performance is achieved when the lens is implanted in both eyes. Benefits are apparent with individuals in whom the lens is used in only one eye as well.

Clinical data demonstrates that the Tecnis symfony multifocal IOL greatly reduces dependence on glasses or bifocals:

  • Over 94% of patients said they would choose the Tecnis symfony multifocal lens again.
  • Nearly 9 out of 10 patients enjoy freedom from glasses after receiving the Tecnis symfony multifocal lens.

Everyone’s focusing ability is different. Most people will be able to see clearly in the distance, have very good reading vision and functional intermediate vision without glasses, but some people may be more comfortable with additional correction, particularly for long periods of computer work.

After surgery with the Tecnis symfony multifocal lens, it may be necessary for some people to wear glasses for distance, intermediate and/or near vision to obtain optimal visual acuity. The difference from traditional lenses is that most people will not be as dependent on these supplemental vision aids to function normally.

 

WHO IS A GOOD CANDIDATE FOR THE Tecnis SYMFONY MULTIFOCAL IOL?

Virtually everyone who has cataracts and/or presbyopia (loss of ability to refocus vision, noticed after age 40) and is in good general health may be candidate for refractive lens exchange and/or cataract surgery with the Tecnis symfony multifocal. During your eye exam, we will determine if there are pre-existing conditions that would make lens replacement surgery with the Tecnis symfony multifocal lens not advisable.

People who have had prior corneal refractive surgery (i.e. LASIK, iLASIK, or PRK) may be acceptable candidates for Tecnis symfony multifocal IOL implantation as long as their eyes are in good health. After a thorough examination, we will be able to better advise you if you qualify for the Tecnis symfony multifocal implant. Also individuals with more extreme levels of nearsightedness or farsightedness may be better candidates for lens replacement surgery with the Tecnis symfony multifocal lens than laser vision correction.

WHAT CAN I EXPECT AFTER THE PROCEDURE?

Similar to other lens implant procedures, you can expect your vision to be good the day following surgery. There is minimal discomfort after surgery that usually resolves within hours. Most individuals can return to a normal work schedule/routine the day after surgery.

HOW SOON AFTER THE PROCEDURE WILL I BE ABLE TO SEE AT VARYING DISTANCES?

For most Tecnis IOL patients, near vision is good the next day, and improves over the following week. Results are best when both eyes have Tecnis symfony multifocal lenses implanted.

WHAT IS THE DIFFERENCE BETWEEN THE Tecnis MULTIFOCAL LENS AND A TRADITIONAL INTRAOCULAR LENS (IOL)?

The Tecnis symfony multifocal lens allows for continuous vision up close, far away and at all distances in between, in most cases with patients experiencing the same vision they had when they were younger, without the inconvenience of corrective lenses.

In contrast, traditional (single vision, fixed focus) lens implants provide vision at a fixed distance and do not have the ability to provide a full range of near, intermediate and far vision. Most people with single vision implants must wear glasses for near vision and may need to wear glasses for intermediate/arm’s length vision as well.

Lens Comparison Chart – Sifri Eye Center

Comparison Chart of Presbyopia-correcting Lens Implants

INTRAOCULAR LENS (IOL) TYPE TRADITIONAL MONOFOCAL LENS ASTIGMATISM CORRECTING LENS TECNIS SYMFONY MULTIFOCAL LENS
ASTIGMATISM CORRECTION No Yes Yes
ZONES OF BEST VISION WITHOUT
GLASSES
1) Distance (TV, Driving)
2) Mid-Range (computer, desk-work)
3) Near (reading documents up-close)
Bifocals required for Distance and Near Distance Only Distance, Intermediate, and Near
NEED FOR GLASSES AFTER SURGERY Bifocals or progressives Reading glasses needed for midrange and near Rarely glasses are needed for maximum vision
STRENGTHS AND BENEFITS OF THE LENS IMPLANT • Improved vision through bifocal glasses • Excellent vision far away without glasses • Excellent far and near vision
• Good computer vision (mid-range)
• Ability to read small print and cell phones in all lighting environments
WEAKNESSES OR SIDE-EFFECTS OF THE LENS IMPLANT • Glasses needed full-time for best vision
• Does not correct astigmatism
• No ability to refocus mid-range (computer) or near (reading printed documents)
• Patients will definitely use glasses to see computer and reading distances
May experience minor glare and halo's that will likely fade over time

Two convenient locations:
2745 Anderson Ferry Rd in Cincinnati
10400 New Haven Rd. in Harrison

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513-922-1550

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