How to choose the lens implant?
Basic decision is to go for monofocal or multifocal lenses.
A. Options with Monofocal lenses–
- Good distance vision, glasses for reading-
If you have always had reading glasses and do not mind wearing them then a safe bet is to go for good distance vision with monofocal lenses and use reading glasses.
- Monvision- one eye for distance one for near.
Some people are used to monovision with contact lenses i.e. one eye (usually dominant eye) focused for distance and the other eye for reading (equivalent to 2-2.5 D). This can be replicated with the monofocal lens implant as well. The lens power can be chosen in each eye so that the lens for one eye is focused for distance and the other eye for near.
If someone is not used to monovision then this can be difficult for some people to adjust to due to the difference in between the two eyes.
- Mini-monovision- one eye for distance and the other eye for intermediate vision (e.g. computer distance/supermarket shelf -1.0D).
This can be a good option for some as it provides a range of vision without glasses but usually needs readers for fine print or prolonged reading. Due to smaller difference in between the two eyes the difference is tolerated well.
B. Multifocal lenses– these lenses can focus for both distance and near and reduce dependence on glasses. Majority of the patients can be spectacle independent.
These are also associated with glare and halos that need weeks to months to adjust to. In some cases these may persist and rarely these are disabling enough such that a lens exchange may be required.
These are not suitable for some people including those with lazy eye, glaucoma etc.
C. Toric Lenses– these are implanted to correct astigmatism of the eye. Astigmatism means that the shape of the eye is not spherical but is cylindrical. Most people will already have glasses to correct this already. Monfocal lenses can be implanted and glasses are used for further correction of astigmatism.
If the astigmatism is over 1.5-2D then a toric lens can be considered to reduce it. The implantation of this lens needs extra measurements to study the eye and help align the lens in the correction position. Occasionally the lens has to be rotated afterwards to bring it in a better position to reduce the residual astigmatism.
Insurers do not cover premium lenses like multifocal or toric lenses.
Your requirements, previous eye history, examination and test findings will all be taken in to account to help you decide the lens type and the plan the post operative outcome.
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I had cataract surgery to both eyes. I also had upgraded trifocal lenses in both eyes. I am very happy as the cataract symptoms have now gone and I do not need glasses at all. I sit at a computer 90% of my working day. Before the surgery I could not see the screen without glasses and now I do not need them at all.
I am writing to thank you for the care and attention you afforded me recently to remedy the cataracts in both eyes and the astigmatism in my right eye. Throughout you explained clearly your thoughts and proposals for my treatment and set clear expectations about the outcome from the two operations. The expectations you set for long distance and short sight distance have not only been met but been exceeded. I am delighted with the outcome. The two operations were painless and I would recommend anyone who has to undergo such treatment not to be concerned. At all times you provided excellent patient care. As you know I am engaged in the IT industry and in my view the two most important facets to success is the technical solution provided and working closely with my clients. Clearly you have immense technical knowledge and in addition managed to make me feel at ease, comfortable and consequently I gained complete confidence with you. I have been wearing glasses and / or contact lenses for over 50 years and to be able see normally without either is a fantastic feeling. Mr Goyal thank you again for the excellent care you provided to me. If ever the opportunity arises I would be happy to recommend you.
I recently underwent surgery for a cataract in my R eye following a very frightening experience where I had developed complete loss of vision in my R eye over a period of 2 hours. Mr Goyal provided not only incredible expertise but kindness and a sense of humour throughout,I cannot recommend him highly enough.
It was a pleasure to be treated by Mr. Goyal. I was completely relaxed throughout both of my cataract operations performed by him. All went well and true to his word he telephoned me the next morning the ensure that all was well.
Saurabh Goyal is a charming man and an excellent surgeon who exudes quiet confidence in his undoubted abilities. When he successfully carried out bilateral laser iridotomy on my eyes I decided that he was the only surgeon I would choose to perform my cataract surgery. His attention to detail throughout has been meticulous and nothing has been too much trouble for him on my behalf. He is, in short, an immense credit to his Profession.T.D.Ireland B.Sc.,C.Eng.,F.I.Mech.E.