Which lens implants should you have implanted when you have cataract surgery?

A very common question on Google is “Which lens is best for cataract surgery replacement?”

There is a broad range of lens technologies available for implantation at the time of cataract surgery. As with almost every aspect of life, there are expensive and budget options. Lens implants vary by material, design and how they are held inside the eye. There are over three hundred different lenses listed on the ULIB website of intraocular lenses, so how do we choose which one to use?

The fact that there are so many different kinds of lens implants available immediately tells you that the perfect lens has not yet been invented. The perfect lens will be one which comes as close as possible to the natural crystalline lens of the young adult human. It will be crystal clear and will provide seamless focusing ability from a distance to near. That’s the holy grail, and we’re not there yet. What we currently have available are lenses which can provide an elegant compromise to improve the quality of vision and range of focus after cataract surgery.

The first decision we have to make with a patient is whether they need and are suitable for a multifocal lens, an extended focus lens or mono-focal lens implants.

Multifocal lenses provide a range of concentration from a distance to near and give a high level of independence from glasses. In fact, over 90% of patients with multifocal patients never need to use spectacles again. The downside of these lenses is that the presence of both distance and near images in the eye at the same time causes light scatter and this can cause difficulty with glare and halo effects. With mono-focal lens implants, almost all the light is focused at one distance resulting in excellent image quality and microscopic glare or halo effects. The downside of these lenses is the fact that the vast majority of patients will still need to use glasses for at least some activities after cataract surgery. Extended focus lenses are a halfway house with some increased range of concentration and some increased glare/halo effects. The answer to which lens is the”best” solution for a particular person will depend on the health of their eye, their lifestyle and their priorities.

Until we have the perfect lens implants, the only way to ensure that we find the best lens for a patient is with careful preoperative assessment using the most accurate available technology. For an evaluation at the Custom Vision Clinic, call us.