Excellent description and functionality of various iol’s and outcomes. Since most of my time is spent on working at near distances, I chose the enhanced iol set for mid and near distance and use eyeglasses for far distance like driving or watching tv. Advantage of this approach is that it’s easier to make correction for vision changes by simply changing the prescription for your eyeglasses, since iol cannot be changed after surgery.
I had also had an enhanced mono iol set for mid and near blended. As we get older we don't need the distance as much as near and mid. Having to use reading glasses all the time can be very frustrating and putting on distance glasses for going out is ok by me.
I've been legally blind without correction for 46 years. I could not see clearly a foot from my face. I chose monofocal distance. I can see 20/20. I can handle wearing glasses for reading and computer usage.
My wife needs cataract surgery. She currently can read OK without glasses. We are very confused about the differences between near and far monovision. What are the distances - the focal range for each? I have not seen any numbers for this. When does the near, start to get blurry? 6 to 10 feet? Where does the far focus kick in sharply? Does anyone know of these ranges. Any info would be helpful. Thanks.
Hi doc, I have cataract, glaucoma and until recently uveitis. Because of uveitis the cataract surgery was delayed for quite a while, while uveitis was treated with steroid tablets (prednisolone) and drops initially and then steroid drops for quite a long time. My doctor opined against any surgery before uveitis is controlled. Now uveitis is almost gone / quiet I'm told and that I should proceed with the surgery asap! My current eye diagnosis is as follows: 1. S/P LPI (both eyes) -- [Status Post Laser Peripheral Iridotomy??], 2. 360 PS (right eye), -- [360-degree Peripheral Synechiae??] 3. Complicated Cataract (both eyes), 4. PACG (both eyes) . -- [Primary Angle-Closure Glaucoma??] 5. Arthritis 6. H/O CKD. .......................... The "complaint" section says: Visual Acuity: Aided. Right Eye: 6/18 p +2.50. Left Eye: 6/9 Plano Add +2.50. Anterior chamber: OD Quiet. OS: Quiet. IOP: OD: 18 mm Hg (NCT). OS: 20 mm Hg (NCT). Iris: OD: 350PS. Lens: OD: lental opacity. OS: Early lental opacity. Fundus: OD: Looks normal. OS: Looks normal. --------------------------- "Surgery Order" says: "1. Phaco with PCIOL (right eye) local anesthesia with Synachiolysis+ iris hook under oral steroid coverage". --------------------------- I was hoping to use "Clareon Vivity IOL" (EDOF) because I work with _computers and near and intermediate vision related work mostly,_ but my doctor says premium/multifocal IOLs are not advisable in my case since (to the best of my understanding of what he said!) if "Synachiolysis+ iris hook" unravels sometime after the surgery or in future, multifocal IOL will become totally useless, even detrimental. Which is a very undesirable situation. He recommends standard monofocal. *MY QUESTIONS ARE:* 1. Is Alcon "Clareon Vivity IOL" a "multifocal" IOL really? My understanding was that it's something different due to new technologies although it covers some of the multifocussing benefits of a "multifocal" lens. Vivity/Clareon is VERY new in my country and I suspect my doctor may not be familiar with it and thinks it is "multifocal". I checked last year and it was not available in my country at that time, but Vivity is now available (probably except Clareon though). *_So my questions are again:_* *1.* Is Alcon "Clareon Vivity IOL" a "multifocal" IOL ? Is it appropriate in my condition in your opinion, especially in case of ""Synachiolysis+ iris hook"? If you think it's okay, then what can I say to my doctor to explain / query this? *2.* What would you recommend as safe & most suitable in my case from the following (available from my Eye hosp): Monofocal Aspheric (Zeiss/Alcon/J&J/Hoya) / Monofocal Plus (Alcon/J&J/BVI/RAYNER). Also: Alcon Vivity (it looks like Clareon Vivity may still not be available here, it's probablly mostly Vivity AcrySof IQ/Restor/SP/Toric/Sert). *3.* What's your view on Monofocal Plus / Enhanced in my condition if Clareon Vivity is not suitable or available? Please help!
Hi. I'm not a doc, please refer my the channel description and about section of my web site. Coming back to your question - the Vivity is not multifocal, it is non-diffractive EDOF IOL, and if there is some issues with pupil which may affect lens performance I'd think about the enhanced monofocal setup, maybe with mini-mono vision approach to extend depth of field. Examples are JnJ Eyhance, BVI IsuPore, Rayner RayOne EMV, Hoya Vivinex Impress, Hanita Extend. Clareon is a material, it is not about lens optics. Vivity is lens based on a new material. Hope it helps
Hello, I also have uveitis in my eye. Hasn't been active for two years. I need surgery. Which lens was applied to your eye? Are you satisfied? Thank you
Thanks for the info on Mono Focal lenses - That is what I am intending to get for both my eyes in November surgeries. I probably have some kind of astigmatism in my eyes, but not getting Toric lenses - insurance does not cover these Toric or enhanced lenses - which is kind of a bummer. I hope glasses can correct my astigmatism like it did before I had cataracts. I was also near sighted. Time shall Tell how it goes for me. Watching allot of You Tube videos.
thank you for your comments,. yes, glasses will correct any remaining optical issues. the current trend is to reduce dependence of glasses with enhanced, toric and premium presbyopia corretcting IOLs
It's very bizarre but my older brother is highly myopic and has a monofocal IOL (Bausch&Lomb MX60) implanted in 2018 with a +4 power in both eyes. He has 20/20 distance vision and required no glasses for intermediate vision and was even able to read his phone at the normal distance. I can't understand how this is possible. Advance to today and his vision is still 20/20 but now he uses +1 for reading and using the computer. Unbelievable! Please explain! I had cataract surgery recently (the same age as my brother "60" when he had his) and had an Alcon Clareon SY60WF +6.5 in both eyes. My vision is 20/25 and I need +2.5 to +3 readers for my phone and +1.25 for intermediate distance. I heard this is a good result but I really wish I got the MX60. I tried to convince my doc but she said both lenses were on the same level technically. thanks
it is perfectly good example of what I'v briefly mentioned in my video - a good range of vision with the monofocal IOL. I can give some suggestions why it may happen, and the real answer might be found during detailed ophthalmic examination. So the possible reasons of good range of vision with monofocal lens are 1. Residual astigmatism 2. Residual positive corneal aberration 3. A corneal refractive profile and it might be the lucky combination of all the 3. Human eye is a combination of cornea + the lens. And to have good range of vision we do need either accommodation or pseudoaccomodation like with premium presbyopia correcting IOL (lens). And, if the lens or IOL is a monofocal, but the cornea has a certain level of factors giving the lucky patient a pseudo accommodation, it will work. And, in case of your brother, most probably multifocal IOL would result in bad vision, as the eye might have too much optical aberrations. So it is a lucky exception.
@@iol-adviser Thanks very much for your comprehensive reply. :-) The only other element I left out is that he had his lenses removed by Laser. My doctor said there was no particular advantage for me. Anyway, looks like maybe there was, at least for him. Also, he said when the laser fired it was like a mirror shattering into innumerable fragments and was quite breathtaking! I wish he'd mentioned that before. Thanks for your content!
I have mild astigmatism. And PVD in my left and mild cataract in both eyes..Vision and reading is still very good..Which type of lens would you recommend?
On the IOL questionnaire, there is another option for the glasses questions, which is "I am fine with wearing glasses". What I do not want is to be putting glasses on and taking them off all the time. I have tri-focal glasses now with no problems, and I'd be fine wearing glasses all the time after the surgery. I want what will give me the clearest vision, with the least amount of glare and distortion. I don't know if a regular mono IOL or some enhanced version would be better? What I am confused about, however, is all the different brands and manufacturers for the same type of IOL. There seem to be some differences in brands for the same type of lens, based on the comments. How would I know which brand of IOL would be appropriate, and is one brand better than another? How do brands of IOL compare?
A great comment and excellent question. I have video about IOL specs and characteristics called 1. Presbyopia or multifocal cataract lens and use of glasses 2. Cataract lenses specs or Vision Quality with cataract lenses Both videos will give you understanding on the different brands pros and cons
After considerable research, as well as a consultation with Alex, I chose the J&J Eyhance for both eyes 2 1/2 years ago. I did a lot of searching for the right ophthalmologist at the same time, as those lenses were new and not widely adopted. I was incredibly pleased with the outcome. I have 20/20 distance vision and quite good intermediate vision (no glasses needed for anything beyond arm's length). Even my reading quality is good enough if I accept a bit of eye strain, but for reading I use +2.0 reading glasses. What surprised me was the quality and usefulness of my near vision (even at 6 to 8 inches), good enough for anything less detailed than threading a needle. This makes me wonder now if the compromise I made in giving up the 20/15 vision of the standard J&J lens was really necessary.
I am pleased for you. How's the night vision? How is your mid- and long-distance vision in dimly lit environments? Can you compare this to your old healthy eye? Your glasses prescription is +2, how can you see without glasses?
@@atalayonline Night vision is good. Virtually no problems with glare, halos, starbursts, etc. Low-light vision is good. I don't need glasses at all except for reading small print (newsprint or smaller) within 24 inches. I am reading my message online perfectly well as I type it on a desktop computer. I do sometimes use my readers for working on a laptop. I could not be more pleased with the outcome. Your mileage may vary, of course.
@@markalexander832 You said, "Of course, your mileage may vary." I don't quite understand what you mean here, can you elaborate a little more? Also, did you choose this lens because it has less contrast loss and better night vision? I think this lens is a little more advanced than monofocal.
I'll be getting my first eye done with Monofocal (Torics) in a week or two. I was born Myopic with my right eye about twice as myopic as my left. I'll be going with the Monofocal IOL because I've been wearing glasses for over 60 years now and don't have a problem with glasses for intermediate or close work. Besides the price, the "no glasses from far to near" IOL's have a downside...if you're outside at night or in low light these "premium" lenses transmit about 30% less light than Monofocals and are also subject to "Halo" effects.
I have monofocal lens. Super distance vision 20/20 20/15 and contrast. My night driving is so clear and bright.. Age 73. All multifocal lens have issues. The monofocal lens is still the gold standard for sharpest distance vision and night vision.. Reading glasses for small print no big deal.
I stopped implanting multi focal IOLs. There are many patients in my practice who had cataract surgery done elsewhere with a multifocal lens implant and they still wear glasses. Some people hate them, and I have had to remove them in a few cases. There are also people who love them, the problem is you never know in advance who will and who will not tolerate a multifocal implant. I just can’t spend hours of chair time, trying to placate an unhappy, bitter, angry, multifocal lens implant patient. 99+ percent of our cataract patients have had a natural monofocal lens in their eyes since they were 45 years old and putting in a monofocal lens implant isn’t disrupting their life very much! They still have a monofocal lens but now they can see, that’s a pretty good deal. And I have a lot of patients in my practice who had a multifocal implant placed elsewhere and they never should’ve got it in the first place. They might have keratoconus, or be post RK, or have some macular degeneration. They might have irregular astigmatism or some kind of corneal dystrophy. There’s so many reasons why you really should not be putting in a multifocal in certain patients. There are lots of patients who are very glad they had them and spent the out-of-pocket money for them, but I can never figure out who in advance who those people are going to be so I just don’t do it anymore.
if a person uses progressive lenses (glasses) after surgery, will they still need to use different powered glasses to see different distances if they choose a monofocal IOL?
Hello Aleksi, I have improved myself a lot thanks to your wonderful videos. I am grateful to you for this. I would like to ask you a question, if you had to have cataract surgery today, would you prefer multifocal or monofocal? And what would be your brand choice?
Your videos are very helpful and I thank you. I've had my dominant right eye done which was supposed to be set for distance. The doc insisted that he needed to correct 1.50 astigmatism in that eye with laser, which he did. The lens he used was the J&J DIB00, +22.5D. The results are that I have excellent near vision to about 5 feet and then it drops off. My dilemma now is what to choose for the non-dominant left eye. He suggested trying Mono Vision and I now have a contact in my left eye to try it out. My concern is whether Mono Vision will work as well for me since the dominant eye should be set for distance, (to my understanding) but my dominant eye is definitely giving me clear, near vision. I am 68 and concerned about losing depth perception as I age, should I choose monovision. Maybe it would be best to have my other eye to match the first one and just wear glasses.
Sorry to hear that. Well, the decision depends on your needs. Doing non-dominant eye for far having dominant for near shall work ok, as eye dominance may change in case of vision changes, so you may expect that left eye will became dominant and problem will be solved. Having both eyes at the same refraction and glasses for far will be an option. But you shall answer yourself do you really want glasses. Depth shall be safe if eyes difference is in range of 1..1.5D. And do define actual right eye refraction a manual fogging technique or maximum-plus technique shall be used (no autorefractor). Hope this helps.
I opted for the Eyehance implants. To further enhance near vision I had the surgeon put -.5 in my non dominant eye. It works, but there's going to be an adaptation period. Blended vision, I've heard it called. Then. To moot all of the above, I ordered top of the line progressives.🤷 Something is bound to work... I hope.
It works. And it’s called mini-monovision. Blended vision is a combination of different lenses. Near vision glasses needs will be defined by the near vision activity. Why progressives ? Generally simple readers is enough.
@@iol-adviser Thanks for the response! It's because progrresives stay on my face. They will have Transitions Xtractive for sun exposure, too. And , I've worn them for years and am accustomed to them. Besides that, I'd go through dozens of readers and sunglasses every year, losing them, sitting on 'em, etc. The rest of the time I'd be looking for them... 🙄 Thanks for asking! With my lifestyle, I just want to have everything covered as simply and effectively as possible. My optometrist hasn't done progressives with Eyehance lenses so it's a bit of an experiment.
@@iol-adviserI got a Toric monofocal 3 weeks ago. I can see my dash in the car just fine, but not nearly as good as my distance vision if that helps. However my distance vision is better now than ever before in my life….20/10 in the eye that had the surgery….no cataract in the other eye.
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Excellent description and functionality of various iol’s and outcomes.
Since most of my time is spent on working at near distances, I chose the enhanced iol set for mid and near distance and use eyeglasses for far distance like driving or watching tv.
Advantage of this approach is that it’s easier to make correction for vision changes by simply changing the prescription for your eyeglasses, since iol cannot be changed after surgery.
Thank you for your comment!
Yes, for that case your setup is perfect 👍
I had also had an enhanced mono iol set for mid and near blended. As we get older we don't need the distance as much as near and mid. Having to use reading glasses all the time can be very frustrating and putting on distance glasses for going out is ok by me.
I've been legally blind without correction for 46 years. I could not see clearly a foot from my face. I chose monofocal distance. I can see 20/20. I can handle wearing glasses for reading and computer usage.
Which BRAND is that Monofocal lens
Thank u kindly dly. Great explaination! Gratefu!
many thanks for your comment and support!
My wife needs cataract surgery. She currently can read OK without glasses. We are very confused about the differences between near and far monovision. What are the distances - the focal range for each? I have not seen any numbers for this. When does the near, start to get blurry? 6 to 10 feet? Where does the far focus kick in sharply? Does anyone know of these ranges. Any info would be helpful. Thanks.
Hi doc,
I have cataract, glaucoma and until recently uveitis. Because of uveitis the cataract surgery was delayed for quite a while, while uveitis was treated with steroid tablets (prednisolone) and drops initially and then steroid drops for quite a long time. My doctor opined against any surgery before uveitis is controlled. Now uveitis is almost gone / quiet I'm told and that I should proceed with the surgery asap!
My current eye diagnosis is as follows:
1. S/P LPI (both eyes) -- [Status Post Laser Peripheral Iridotomy??],
2. 360 PS (right eye), -- [360-degree Peripheral Synechiae??]
3. Complicated Cataract (both eyes),
4. PACG (both eyes) . -- [Primary Angle-Closure Glaucoma??]
5. Arthritis
6. H/O CKD.
..........................
The "complaint" section says: Visual Acuity: Aided. Right Eye: 6/18 p +2.50. Left Eye: 6/9 Plano Add +2.50.
Anterior chamber: OD Quiet. OS: Quiet.
IOP: OD: 18 mm Hg (NCT). OS: 20 mm Hg (NCT).
Iris: OD: 350PS.
Lens: OD: lental opacity. OS: Early lental opacity.
Fundus: OD: Looks normal. OS: Looks normal.
---------------------------
"Surgery Order" says: "1. Phaco with PCIOL (right eye) local anesthesia with Synachiolysis+ iris hook under oral steroid coverage".
---------------------------
I was hoping to use "Clareon Vivity IOL" (EDOF) because I work with _computers and near and intermediate vision related work mostly,_ but my doctor says premium/multifocal IOLs are not advisable in my case since (to the best of my understanding of what he said!) if "Synachiolysis+ iris hook" unravels sometime after the surgery or in future, multifocal IOL will become totally useless, even detrimental. Which is a very undesirable situation. He recommends standard monofocal.
*MY QUESTIONS ARE:*
1. Is Alcon "Clareon Vivity IOL" a "multifocal" IOL really? My understanding was that it's something different due to new technologies although it covers some of the multifocussing benefits of a "multifocal" lens. Vivity/Clareon is VERY new in my country and I suspect my doctor may not be familiar with it and thinks it is "multifocal". I checked last year and it was not available in my country at that time, but Vivity is now available (probably except Clareon though).
*_So my questions are again:_*
*1.* Is Alcon "Clareon Vivity IOL" a "multifocal" IOL ? Is it appropriate in my condition in your opinion, especially in case of ""Synachiolysis+ iris hook"? If you think it's okay, then what can I say to my doctor to explain / query this?
*2.* What would you recommend as safe & most suitable in my case from the following (available from my Eye hosp): Monofocal Aspheric (Zeiss/Alcon/J&J/Hoya) / Monofocal Plus (Alcon/J&J/BVI/RAYNER). Also: Alcon Vivity (it looks like Clareon Vivity may still not be available here, it's probablly mostly Vivity AcrySof IQ/Restor/SP/Toric/Sert).
*3.* What's your view on Monofocal Plus / Enhanced in my condition if Clareon Vivity is not suitable or available?
Please help!
Hi. I'm not a doc, please refer my the channel description and about section of my web site.
Coming back to your question - the Vivity is not multifocal, it is non-diffractive EDOF IOL, and if there is some issues with pupil which may affect lens performance I'd think about the enhanced monofocal setup, maybe with mini-mono vision approach to extend depth of field. Examples are JnJ Eyhance, BVI IsuPore, Rayner RayOne EMV, Hoya Vivinex Impress, Hanita Extend.
Clareon is a material, it is not about lens optics. Vivity is lens based on a new material.
Hope it helps
Hello, I also have uveitis in my eye. Hasn't been active for two years. I need surgery. Which lens was applied to your eye? Are you satisfied?
Thank you
Thanks for the info on Mono Focal lenses - That is what I am intending to get for both my eyes in November surgeries. I probably have some kind of astigmatism in my eyes, but not getting Toric lenses - insurance does not cover these Toric or enhanced lenses - which is kind of a bummer. I hope glasses can correct my astigmatism like it did before I had cataracts. I was also near sighted.
Time shall Tell how it goes for me. Watching allot of You Tube videos.
thank you for your comments,. yes, glasses will correct any remaining optical issues. the current trend is to reduce dependence of glasses with enhanced, toric and premium presbyopia corretcting IOLs
It's very bizarre but my older brother is highly myopic and has a monofocal IOL (Bausch&Lomb MX60) implanted in 2018 with a +4 power in both eyes. He has 20/20 distance vision and required no glasses for intermediate vision and was even able to read his phone at the normal distance. I can't understand how this is possible. Advance to today and his vision is still 20/20 but now he uses +1 for reading and using the computer. Unbelievable! Please explain! I had cataract surgery recently (the same age as my brother "60" when he had his) and had an Alcon Clareon SY60WF +6.5 in both eyes. My vision is 20/25 and I need +2.5 to +3 readers for my phone and +1.25 for intermediate distance. I heard this is a good result but I really wish I got the MX60. I tried to convince my doc but she said both lenses were on the same level technically. thanks
it is perfectly good example of what I'v briefly mentioned in my video - a good range of vision with the monofocal IOL.
I can give some suggestions why it may happen, and the real answer might be found during detailed ophthalmic examination.
So the possible reasons of good range of vision with monofocal lens are
1. Residual astigmatism
2. Residual positive corneal aberration
3. A corneal refractive profile
and it might be the lucky combination of all the 3.
Human eye is a combination of cornea + the lens.
And to have good range of vision we do need either accommodation or pseudoaccomodation like with premium presbyopia correcting IOL (lens). And, if the lens or IOL is a monofocal, but the cornea has a certain level of factors giving the lucky patient a pseudo accommodation, it will work.
And, in case of your brother, most probably multifocal IOL would result in bad vision, as the eye might have too much optical aberrations.
So it is a lucky exception.
@@iol-adviser Thanks very much for your comprehensive reply. :-) The only other element I left out is that he had his lenses removed by Laser. My doctor said there was no particular advantage for me. Anyway, looks like maybe there was, at least for him. Also, he said when the laser fired it was like a mirror shattering into innumerable fragments and was quite breathtaking! I wish he'd mentioned that before. Thanks for your content!
I have mild astigmatism. And PVD in my left and mild cataract in both eyes..Vision and reading is still very good..Which type of lens would you recommend?
On the IOL questionnaire, there is another option for the glasses questions, which is "I am fine with wearing glasses". What I do not want is to be putting glasses on and taking them off all the time. I have tri-focal glasses now with no problems, and I'd be fine wearing glasses all the time after the surgery. I want what will give me the clearest vision, with the least amount of glare and distortion. I don't know if a regular mono IOL or some enhanced version would be better?
What I am confused about, however, is all the different brands and manufacturers for the same type of IOL. There seem to be some differences in brands for the same type of lens, based on the comments. How would I know which brand of IOL would be appropriate, and is one brand better than another? How do brands of IOL compare?
A great comment and excellent question.
I have video about IOL specs and characteristics called
1. Presbyopia or multifocal cataract lens and use of glasses
2. Cataract lenses specs or Vision Quality with cataract lenses
Both videos will give you understanding on the different brands pros and cons
After considerable research, as well as a consultation with Alex, I chose the J&J Eyhance for both eyes 2 1/2 years ago. I did a lot of searching for the right ophthalmologist at the same time, as those lenses were new and not widely adopted. I was incredibly pleased with the outcome. I have 20/20 distance vision and quite good intermediate vision (no glasses needed for anything beyond arm's length). Even my reading quality is good enough if I accept a bit of eye strain, but for reading I use +2.0 reading glasses. What surprised me was the quality and usefulness of my near vision (even at 6 to 8 inches), good enough for anything less detailed than threading a needle. This makes me wonder now if the compromise I made in giving up the 20/15 vision of the standard J&J lens was really necessary.
Thank you for your feedback! And I’m happy for your results! Replied under your other comment :)
I am pleased for you. How's the night vision? How is your mid- and long-distance vision in dimly lit environments? Can you compare this to your old healthy eye? Your glasses prescription is +2, how can you see without glasses?
@@atalayonline Night vision is good. Virtually no problems with glare, halos, starbursts, etc. Low-light vision is good. I don't need glasses at all except for reading small print (newsprint or smaller) within 24 inches. I am reading my message online perfectly well as I type it on a desktop computer. I do sometimes use my readers for working on a laptop. I could not be more pleased with the outcome. Your mileage may vary, of course.
@@markalexander832 You said, "Of course, your mileage may vary." I don't quite understand what you mean here, can you elaborate a little more? Also, did you choose this lens because it has less contrast loss and better night vision? I think this lens is a little more advanced than monofocal.
@@markalexander832 I'm so glad you're okay.🙏
I'll be getting my first eye done with Monofocal (Torics) in a week or two. I was born Myopic with my right eye about twice as myopic as my left. I'll be going with the Monofocal IOL because I've been wearing glasses for over 60 years now and don't have a problem with glasses for intermediate or close work. Besides the price, the "no glasses from far to near" IOL's have a downside...if you're outside at night or in low light these "premium" lenses transmit about 30% less light than Monofocals and are also subject to "Halo" effects.
nice video man
many thanks!
You did not point out that you can get progressive eye glasses for reading or distance
thank you for your comments. there is many options to mention - including ICL, contact lenses, multifocal contact lenses, etc..
I have monofocal lens. Super distance vision 20/20 20/15 and contrast. My night driving is so clear and bright.. Age 73. All multifocal lens have issues. The monofocal lens is still the gold standard for sharpest distance vision and night vision.. Reading glasses for small print no big deal.
Cab you see computer without glasses?
@@MuhammadAli-hj2fe Need glasses for computer but I buy blue light readers which should be worn by everyone using computer screens
with monofocal + readers it may be issue with intermediate, depends on the lifestyle
Which lens you choose
I stopped implanting multi focal IOLs. There are many patients in my practice who had cataract surgery done elsewhere with a multifocal lens implant and they still wear glasses. Some people hate them, and I have had to remove them in a few cases. There are also people who love them, the problem is you never know in advance who will and who will not tolerate a multifocal implant. I just can’t spend hours of chair time, trying to placate an unhappy, bitter, angry, multifocal lens implant patient. 99+ percent of our cataract patients have had a natural monofocal lens in their eyes since they were 45 years old and putting in a monofocal lens implant isn’t disrupting their life very much! They still have a monofocal lens but now they can see, that’s a pretty good deal. And I have a lot of patients in my practice who had a multifocal implant placed elsewhere and they never should’ve got it in the first place. They might have keratoconus, or be post RK, or have some macular degeneration. They might have irregular astigmatism or some kind of corneal dystrophy. There’s so many reasons why you really should not be putting in a multifocal in certain patients. There are lots of patients who are very glad they had them and spent the out-of-pocket money for them, but I can never figure out who in advance who those people are going to be so I just don’t do it anymore.
Needs subtitles in English
if a person uses progressive lenses (glasses) after surgery, will they still need to use different powered glasses to see different distances if they choose a monofocal IOL?
Not fully progressive. Progressive corrects distance - intermediate - near. Monifocal will correct far, so intermediate - near yes , far - no glasses.
exact question i wanted to ask brother
Hello Aleksi, I have improved myself a lot thanks to your wonderful videos. I am grateful to you for this. I would like to ask you a question, if you had to have cataract surgery today, would you prefer multifocal or monofocal? And what would be your brand choice?
Your videos are very helpful and I thank you.
I've had my dominant right eye done which was supposed to be set for distance. The doc insisted that he needed to correct 1.50 astigmatism in that eye with laser, which he did. The lens he used was the J&J DIB00, +22.5D. The results are that I have excellent near vision to about 5 feet and then it drops off. My dilemma now is what to choose for the non-dominant left eye. He suggested trying Mono Vision and I now have a contact in my left eye to try it out. My concern is whether Mono Vision will work as well for me since the dominant eye should be set for distance, (to my understanding) but my dominant eye is definitely giving me clear, near vision. I am 68 and concerned about losing depth perception as I age, should I choose monovision. Maybe it would be best to have my other eye to match the first one and just wear glasses.
Sorry to hear that.
Well, the decision depends on your needs.
Doing non-dominant eye for far having dominant for near shall work ok, as eye dominance may change in case of vision changes, so you may expect that left eye will became dominant and problem will be solved. Having both eyes at the same refraction and glasses for far will be an option. But you shall answer yourself do you really want glasses. Depth shall be safe if eyes difference is in range of 1..1.5D. And do define actual right eye refraction a manual fogging technique or maximum-plus technique shall be used (no autorefractor).
Hope this helps.
I opted for the Eyehance implants. To further enhance near vision I had the surgeon put -.5 in my non dominant eye. It works, but there's going to be an adaptation period. Blended vision, I've heard it called.
Then. To moot all of the above, I ordered top of the line progressives.🤷
Something is bound to work... I hope.
It works. And it’s called mini-monovision. Blended vision is a combination of different lenses. Near vision glasses needs will be defined by the near vision activity.
Why progressives ? Generally simple readers is enough.
@@iol-adviser Thanks for the response! It's because progrresives stay on my face. They will have Transitions Xtractive for sun exposure, too. And , I've worn them for years and am accustomed to them.
Besides that, I'd go through dozens of readers and sunglasses every year, losing them, sitting on 'em, etc. The rest of the time I'd be looking for them... 🙄
Thanks for asking! With my lifestyle, I just want to have everything covered as simply and effectively as possible. My optometrist hasn't done progressives with Eyehance lenses so it's a bit of an experiment.
With monofocal lens to see distance...will I have to wear glasses to see car instruments?
It depends on car , distance and size of the dashboard, generally it will be not comfortable
@@iol-adviserI got a Toric monofocal 3 weeks ago. I can see my dash in the car just fine, but not nearly as good as my distance vision if that helps. However my distance vision is better now than ever before in my life….20/10 in the eye that had the surgery….no cataract in the other eye.
I think one can wear progressive glasses
Yes, why didn’t he mention getting progressives after getting monofocal iols set to distance?
Зыс нон-офтальмолоджист из райт - ай мэй конфирм, эз эн овнер оф ЕДОФ. :)
Many thanks ))