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How you are going to decide whether you want a prime intraocular lens or a standard monofocal intraocular lens?

Lens choice is a crucial decision because, when your natural lens which has got a cataract is removed, your surgeon will be placing at the time of removal a new lens called an intraocular lens (IOL). The IOL can be monofocal, set for a single distance or it can be a prime lens which allows you to see at different distances. There are advantages and disadvantage of both of these, and in my previous blog I have told you a little bit about the monofocal lens, that is chosen to a specific power either to give you clear vision for near or distance, depending on what you are used to seeing without glasses. If a monofocal IOL is used to give you clear distance vision, you will require reading glasses. If a monofocal lens is used to provide you with clear near vision, as if you were a short-sighted person (myope), you will require spectacle correction for distance. 

In this blog post, I want to concentrate on the advantages and disadvantages of a prime intraocular lens, often also known as multifocal IOL. First of all, the prime intraocular lens is not covered financially by your private medical insurance, and there is an additional fee for you to pay for the lens and to the surgeon for inserting this particular lens when you have your phaco-cataract surgery. A premium contact lens is a multifocal intraocular lens and aims to correct your vision after cataract surgery without the need for glasses either for near or distance. 

Advantages and disadvantages of a multifocal IOL

If your primary complaint has been glare and halos because of, for instance, a posterior subcapsular cataract or a cortical cataract, many patients decide that they do not want to have glasses particularly for distance or near and want to have a multifocal lens. One of the disadvantages of a multifocal lens can be that they can still cause a little bit of glare and halo. Prime intraocular lenses are multifocal intraocular lenses, and they decrease your need for reading glasses or computer glasses after cataract surgery but do not always eradicate the need. They work very much like a multifocal contact lens. They add magnification at different parts of the lens to expand your range of vision so that you can see near objects better without glasses or contact lenses.

Some of the developments of the multifocal intraocular lenses have led to you being able to get to better near vision with accommodating lenses, but because of the risk of them causing glare or mild blurred distance vision, you have to consider that the trade-off between the lack of glasses and the glare and mild blurred distance vision. This does indeed sound complicated! You have to have a good chat with your ophthalmic surgeon, Mr Khan or Miss Crawley, to gather their opinion of what is best for you, the advantages and disadvantages of a prime lens, as it is not as straightforward as a monofocal IOL.

Your cataract surgeon will help you decide whether or not you are a candidate for the multifocal or prime intraocular lens when you see them at your preoperative examination and consultation. They will tell you about the Tecnis Multifocal IOL and the AcrySof IOL.


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