Clear Lens Extraction

In patients who do not qualify for laser vision Correction or who have not developed cataract formation, removal of the natural lens of the eye and replacement with an intraocular lens (IOLs) may be helpful in reducing their dependence on glasses or contact lenses. This procedure is very similar to cataract surgery that is done for a cloudy lens. The accuracy in obtaining the desired improvement is quite high. In some patients, multi-focal lenses may be helpful in improving distance, intermediate, and near vision. Some patients may opt for distance vision in both eyes with mono-focal implants Monovision with mono-focal implants may be an option for patients over 40 who have used contact lenses in the past in a way that allows their dominant eye to see clearly for distance and their non-dominant eye to see clearly up close.

Multifocal IOLs
Among the challenges of Clear Lens Extraction, is making the best choice for each patient in order to meet individual needs or preferences in correcting both distance and near vision.

It is important for a patient to determine their particular visual needs and preferences. There are several choices that we have when we do Clear Lens Extractionand place an implant in your eye.

Some choose to read without spectacles, which typically results in the need to wear spectacles for good intermediate and distance vision. These patients do well if we implant lenses in both eyes that leave the patient with about -2.00 Diopters of nearsightedness in both eyes.

Others choose mono-vision, which is correcting one eye for the distance, and the other eye for near vision.

Most patients opt to see sharply for distance and do not mind wearing optical aids for near tasks.

More and more individuals emphasize their desire for functional vision at both distance and near. To meet the needs of this group, multi-focal lens implants are required. Currently there are two brands of multifocal implants approved by the FDA, The ReSTOR Aspheric by Alcon and the ReZoom Multifocal by AMO. Most patients achieve adequate functional vision for many distance, near and intermediate tasks without spectacle correction.

Advantages and Disadvantages of Monofocal versus Multi-focal IOL’s
For distance vision, the monofocal IOL provides the most clarity without loss of contrast. The ReSTOR Aspheric and the ReZoom Multifocal generally provide good distance vision, but in some patients it may not be quite as sharp as with a monofocal IOL. For near vision, the monofocal IOL generally does not provide good, crisp vision without glasses, if the patient has been fully corrected for distance. Intermediate vision is usually better with both types of multifocal lenses, than with the monofocal IOL. The multifocal IOL provides adequate near vision, although spectacle independence is not guaranteed.

Your visual needs/preferences can help determine which IOL is best.
Distance Vision Intermediate Vision Near Vision
Both Eyes Monofocal Distance Best Inadequate Glasses Necessary
Both Eyes Monofocal Near Glasses Necessary Adequate Best
Both Eyes Monofocal (Monovision) Good Adequate Good
Both Eyes Multifocal Good Best Good

Approximately 80% of patients implanted bilaterally with the latest generation of Multifocal IOLs never need to wear eyeglasses. Few wear glasses on a limited basis (such as for driving at night or during prolonged reading), Very few need to wear glasses for near work with the ResTor Aspheric. 15% of patients with bilateral ReZoom implants have difficulty with halos around any point source of light. The decision to have a monofocal vs a multi-focal IOL is best made prior to surgery on your first eye. Some patients opt for a mixture of IOL types depending on their lifestyle and visual needs. Please ask any of our surgeons if you have other questions concerning what is right for you. For more information about multifocal IOLs, please call our office and ask for our surgical coordinator or make an appointment to consult with one of our surgeons.