Multifocal Laser Lens Surgery: A Case Study…

multifocal laser lens surgeryAre you sick of your multifocals? Or think that laser eye surgery is only for distance vision?  For an alternative to multifocal glasses, read on…

Multifocal Laser Lens Case Study

Jenny is fifty-eight. She wears glasses for distance and near vision and also wears contact lenses when she can manage them. As she is long-sighted (about +3 for distance, + 5.50 for reading), she explains that it is difficult for her to actually see the contact lenses on her finger-tip, in order to put them into her eyes correctly.  They are always popping inside out or falling to the floor so they are reserved for social occasions – of which it sounds like there are many. Most of the time she wears glasses and shows me that her bag is chock full of them, several pairs of which seem to be designer sunglasses. Jenny’s eyes are healthy on examination with nothing out of the ordinary. She does have a mild dry-eye condition, which is very common in post-menopausal women, but as she is able to wear her soft contact lenses comfortably, I don’t see her dry eye as a show-stopper. If she proceeded with a LASIK procedure we would ensure that she had plenty of support from artificial tears during the healing period.  More about LASIK and dry eye here

LASIK or Laser Lens Surgery?

We discuss all the vision correction options and although LASIK is an option for Jenny, she is very interested in the idea of laser lens surgery with multifocal lenses.   This is a more invasive procedure than LASIK but also extremely successful and safe, with very low risk of complications in a healthy eye.  LASIK could offer Jenny a blended vision result where one eye would be clearer for distance and the other eye clearer for near vision. However, as LASIK is a corneal procedure, it would mean that as she got older, Jenny would require further eye surgery should she develop cataracts.  One of the advantages of a lens procedure for Jenny would be that her natural crystalline lenses would be replaced once and once only, so she would never have to worry about the trouble or expense of cataract surgery in the future. Once your lenses are replaced you will never develop a cataract.  The other advantage of having a lens procedure instead of a corneal procedure like LASIK is the option of multifocal intra-ocular lenses. When your eye’s own crystalline lenses are removed, we replace them with tiny artificial lenses called intra-ocular lenses and these come in many wonderful designs including multifocal options which provide clear vision for both distance and near for both eyes.

Who is suitable for multifocal IOLs?

Multifocal intra-ocular lenses are not for everyone.  Depending on how strong you want the reading vision to be, they may involve some compromise to the quality and ‘crispness’ of your distance vision, most obvious for tasks such as night driving.  But they do have some marvellous benefits, such as the ability to see with both eyes at a range of distances.  This type of procedure is ideal for someone with vision that is already slightly compromised, due to the development of early-stage cataracts, for example, or even for someone who doesn’t wear their glasses as much as they should and is used to a slight compromise in their vision. Also, personality comes into play in determining if multifocal lens surgery is the best choice of procedure.  It is best suited to people with an easy-going disposition.  We try and avoid recommending them to those who already have exceptional vision with their glasses and might be perfectionists!  The thing is, if you are a very fussy type and you are used to crystal clear vision through your glasses, it is difficult to adjust to any sort of compromise, even if you have the huge upside of independence from glasses brought about by vision correction surgery.

From a long discussion with Jenny, I was confident that she would love the results of multifocal lens surgery.   We scheduled her lens procedures one week apart and from the first post-operative visit she was very positive about the outcome, even though it took her a few months to fully adjust to her distance vision for night driving.  She confided in me that she uses it as an excuse to not be the designated driver. I must admit, that’s an advantage for having multifocal intra-ocular lenses which had never occurred to me…