Multifocal and Accomodating Intraocular Lenses

Multifocal Intraocular Lenses

There are several types of multifocal lenses available today. Each is designed to give you clear distance vision, but can also give you clear intermediate and near vision. These lenses are associated with a high degree of glasses independence in appropriate candidates. That means you may be able to function well without your glasses for many activities compared to individuals with monofocal IOLs. However, you may need to supplement your vision with glasses for certain activities. For example, you may find you are able to drive and see your dashboard, but have difficulty reading your grocery shopping list without glasses. Or, you may be able to drive and use your phone, but are not able to see the computer screen well without glasses. Many patients achieve complete glasses independence with these lenses but, unfortunately, it is impossible to predict in advance of surgery who will enjoy complete glasses independence and who will simply have reduced dependence on glasses. In addition, if you have an astigmatism, you must have it corrected in order to maximize the benefit of these lenses. Otherwise, you will not achieve your maximum level of glasses independence.

Most patients are happy with these lenses. However, they do have some side effects. The design of the lens that allows you to focus at multiple distances can also create halos around and glare from lights. Mostly, this affects patients at night when they are driving. The majority of patients adapt well to this over time, but some patients will also notice decreased contrast sensitivity, which will manifest as a decrease in the sharpness of vision.

Despite these side effects, the majority of patients are happy with these lenses. When surveyed, patients who received these lenses overwhelmingly stated they would choose them again. On occasion, patients will elect to have the lenses removed and replaced with a monofocal IOL due to the side-effect profile. This is uncommon, but if you choose one of these lenses, you should be prepared for this possibility.

ReZoom™ Multifocal IOL

Courtesy of Abbott Medical Optics

TECNIS® Multifocal IOL

Courtesy of Abbott Medical Optics

Illustration of AcrySof^® IQ ReSTOR^® IOL

Photograph Simulating Theoretical Vision With a Multifocal IOL

Accommodating Intraocular Lenses

Accommodating IOLs are designed to function in a manner similar to your native lens. These lenses have hinges and are designed to bend inside your eye with the contraction and relaxation of the ciliary muscles that normally control accommodation. They are sometimes referred to as pseudo-accommodating IOLs for that reason. You may recall from earlier pages that accommodation is the natural process that allows you to focus from distance to near, and at each distance in between. The advantage of these lenses, is that they are not associated with glare, halos, and decreased contrast sensitivity to the same degree as multifocal IOLs. However, they are less effective at achieving glasses independence when compared to multifocal IOLs, because their range of focus is more limited. With these lenses, you can achieve good distance vision and, usually, good intermediate vision. However, you should expect to wear glasses for near work (reading, dialing the phone, operating the television remote, etc.) These lenses work well with a small amount of monovision to increase the range of focus to include near vision, but you must be a suitable candidate for monovision to receive this treatment option.

Illustration of the Crystalens® Accommodating IOL

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