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Multifocal IOLs: Are They the Right Lenses for You?

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A multifocal IOL can offer different levels of vision correction following cataract surgery.

During cataract surgery, your doctor replaces your eye’s cloudy lens with a synthetic version. You can choose the intraocular lens (IOL) type your doctor inserts, and a multifocal version could be just right for you.

About 76 percent of American adults wear prescription glasses or contacts. A multifocal IOL could reduce your reliance on these vision aids. After cataract surgery, you could see better than you ever have before.

What Is a Multifocal IOL?

A standard IOL offers the same vision correction throughout. A multifocal IOL is different. 

The lenses use different optical powers across the lens. Manufacturers etch concentric rings on the surface of the lens, allowing images at various distances to focus on the retina. Eye muscles pull on the lens when you need to focus.

3 Types of Multifocal IOLs

eye with cataracts

While all multifocal IOLs can help people to see objects clearly after cataract surgery, multiple types are available. Variety ensures that you can work with your doctor to find the lenses that are right for you. 
Three general types exist.

  • Refractive: These IOLs have corrective zones, allowing for good far and intermediate vision. Some complain that their close vision isn’t optimized with these lenses, but reading glasses could fix the issue. 
  • Diffractive: These IOLs have vision zones in concentric circles that get closer to each other as they reach the edge of the lens. Diffractive IOLs offer good far and near vision, but intermediate objects could be harder to see clearly.
  • Combined: These lenses apply the best of both manufacturing techniques, offering crisp vision near and far. 

There are three common multifocal lenses for people to choose from.

  • TECNIS Multifocal: This is a fully diffractive IOL with advanced image quality across all distances under all lighting conditions and for all pupil sizes.
  • AcrySof IQ ReSTOR: This brand has a patented apodized diffractive feature to distribute light based on the ambient lighting in a room. It optimizes your image quality in diverse lighting.
  • ReZoom: The multifocal lenses from this brand have five optical zones etched microscopically into the surface, improving near, distant, and intermediate vision.

The best lens depends on several factors, such as the person’s overall eye health, occupation, and lifestyle. The eye doctor will perform an extensive interview and assessment to recommend the best choice.

Pros & Cons of Multifocal IOLs

Multifocal IOLs all work to improve intermediate, far, and near distances. In many cases, after having the lenses implanted, people no longer need to wear corrective lenses to see clearly. The results are usually long-lasting, and there is no upkeep since the lenses are embedded in the eye.

Researchers say close to 96 percent of people with multifocal IOLs achieve vision scores of 20/40 or better, and more than 51 percent get vision scores of 20/20. People like this may not need to wear glasses again. 

There are a few disadvantages to consider as well. Seeing at close distances is sometimes an issue for people with multifocal IOLs. However, reading glasses usually correct this problem.

People who get these lenses as part of cataract surgery may find it hard to read in dim light. While rare, some people develop halos and glare surrounding lights after dark, which can interfere with safe driving at night.
In some studies, multifocal IOLS create more glare and halo issues than standard IOLs, but newer versions are more effective and less likely to cause this problem.

Possible Complications After Surgery

Multifocal intraocular lenses are a good choice for many people. However, it is important to explore the details before agreeing to the procedure.

Possible complications of any cataract surgery include the following:

  • Infections
  • Bleeding
  • Swelling 
  • Detached retina 
  • Pain 
  • Blurry vision
  • Halos, glare, or shadows 
  • Vision loss 

Overall, cataract surgery is very safe, says the American Academy of Ophthalmology. An eye doctor can answer all your questions. This way, once you agree to the surgery, you can be sure that you have made an informed choice.

References

  1. Quick Facts. (December 2021). The Vision Council.
  2. Multifocal Intraocular Lenses: Types, Outcomes, Complications, and How to Solve Them. (October 2017). Taiwan Journal of Ophthalmology.
  3. Efficacy and Safety of Multifocal Intraocular Lenses Following Cataract and Refractive Lens Exchange: Meta-Analysis of Peer-Reviewed Publications. (February 2016). Journal of Cataract and Refractive Surgery.
  4. Effectiveness of Multifocal and Monofocal Intraocular Lenses for Cataract Surgery and Lens Replacement: A Systematic Review and Meta-Analysis. (January 2019). Graefe’s Archive for Clinical and Experimental Ophthalmology.
  5. Cataract Surgery: Risks, Recovery, Costs. (July 2022). American Academy of Ophthalmology.
  6. What Is the Success Rate for Cataract Surgery? (February 2014). American Academy of Ophthalmology.

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