Intraocular Lenses (IOLs) for Eyes

Multifocal, Extended Depth of Focus (EDOF), Monofocal, and Toric Lenses

Get multifocal, EDOF, monofocal, and toric lenses from Sifri Eye Center. Here are their main characteristics:

Multifocal and EDOF

• Corrects vision for far, near, and intermediate distance
  
• Minimizes or eliminates usage of glasses
  
• Partial coverage by Medicare or other insurance

Monofocal

• Provides good vision at one distance (typically far vision)
  
• Requires reading glasses after surgery
  
• Covered by Medicare or private insurance

Toric

• Provides good vision at one distance (typically far vision)
  
• Requires reading glasses after surgery
  
• Partial coverage 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, developing cataracts is a normal part of the aging process. Though not as common, you can also develop cataracts as a child or young adult. 

Signs You May Have a Cataract

We Can Determine If You Have a Cataract

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 despite 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. Astigmatism is not corrected with traditional lens implants.

If you have 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 you would most likely end up with bifocals after surgery for best-corrected vision. 

Bifocals are not necessary for everyone, however reading glasses will be necessary. The strength of reading glasses varies. These glasses can be purchased over the counter and range from +1.00 to +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.

Traditional cataract surgery is typically covered by your medical insurance. You would just pay your co-payment or deductible.

Cataract Surgery With the Astigmatism Correction

We also offer cataract surgery if you have large amounts of astigmatism and if you want to see clearly at a distance without glasses, but don’t mind using glasses to enable you 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 at distance and the astigmatism corrected you'll be able to see very clearly at distance 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 distance vision. Most individuals with an astigmatism-reducing lens will see quite well without glasses at distance.

Most astigmatism-correcting lens implants do not allow an adjustable range of focus. Therefore, though your vision will be clear at distance without glasses, you would require glasses to see up close (near) and at the computer (mid-range) after cataract surgery.

How Astigmatism-Correcting (Toric Lens) IOL Works

The astigmatism-correcting IOL is designed to correct the naturally 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 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 at distance. Individuals with astigmatism-correcting IOL will need bifocal or reading glasses to see up close.

How Well Does the Astigmatism-Correcting IOL Work?

Approximately 95% 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 distance vision. But without their glasses, distance vision will be blurred by any residual astigmatism.

On the other hand, if you have the astigmatism-correcting IOL, you are much less dependent on glasses for your distance vision because the lens implant corrects the natural astigmatism.

Cataract Surgery With Multifocal and EDOF 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  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. Click here to read more about the SYMFONY lens. Click here to read more about the SYNERGY lens. Click here to read more about the VIVITY lens.

When are they Used?

The multifocal and EDOF lenses are 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 multifocal and EDOF 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 these lenses. Just a desire to reduce or eliminate your dependence on glasses is a good reason to opt for this lens.

What Will these Lenses Accomplish?

These lenses have 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 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 the past experience, the following types of patients possibly should not have these lens implants:

• Individuals who 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 Radial Keratotomy (RK) surgery previously
  
• Individuals with pre-existing retina conditions, such as macular degeneration

Who Is a Good Candidate for the Multifocal or EDOF 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 these lenses. During your eye exam, we will determine if there are pre-existing conditions that would make lens replacement surgery with the multifocal or EDOF lenses not advisable.
 

People who have had prior corneal refractive surgery (i.e. LASIK, iLASIK, or PRK) may be acceptable candidates for multifocal or EDOF 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 multifocal or EDOF implant. Also individuals with more extreme levels of nearsightedness or farsightedness may be better candidates for lens replacement surgery with the Multifocal or EDOF lenses 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 multifocal or EDOF IOL patients, near vision is good the next day, and improves over the following week. Results are best when both eyes have these premium lenses implanted. Multiple studies show that with neuro adaption the vision will continue to improve up to six months after surgery.

Multifocal Versus EDOF Versus Traditional IOLs

The multifocal and EDOF lenses allow for continuous near, intermediate, and distance vision, in most cases with patients experiencing the same vision they had when they were younger, without the inconvenience of corrective lenses.

The main difference between multifocal and EDOF lenses is that multifocal lenses can achieve better near vision but are associated with a slight risk of halos and glare driving at night which usually fade with time (six months). The VIVITY EDOF lens gives excellent distance vision, excellent intermediate vision and functional near vision and has less risk of significant halos compared to a multifocal lens; the risk of halos and glare is similar to that of a monofocal lens.

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.

SYMFONY IOL information brochure

SYNERGY IOL information brochure

VIVITY  IOL information brochure