Cataracts: Should you choose monofocal or multifocal intraocular lenses?

Cataracts not only impair vision but also significantly affect quality of life, particularly for the elderly. Did you know that selecting the right type of intraocular lens during surgery can completely transform how you see the world? Which option is best for your eyes? Read on to discover the most suitable solution for you!

Contents

1. What are cataracts?

Cataracts, also known as senile cataracts or age-related cataracts, occur when proteins in the lens clump together, forming cloudy areas that obstruct light from reaching the retina. This condition leads to blurry vision and symptoms such as glare, light sensitivity, and even vision loss. In severe cases, cataracts can cause increased intraocular pressure, redness, and intense eye pain.

Cataracts cause blurred vision with or without glasses. Source: Internet

Cataracts are a common eye condition, especially among older adults, and are the leading cause of blindness worldwide. Although it progresses gradually, the speed of development is unpredictable. Without timely treatment, they can result in permanent vision loss.

2. Surgical treatment for cataracts

The most effective treatment for cataracts is surgical removal and replacement of the natural lens with an artificial one. Two common techniques include:

Phacoemulsification (Phaco): This involves using ultrasound energy to emulsify the cloudy lens, which is then suctioned out through a small incision. An artificial intraocular lens (IOL) is then implanted to restore vision. This is a safe, widely practiced, and well-established method.
Laser Femto Phaco Cataract: This advanced procedure uses a Femtosecond laser for precise incisions, replacing traditional surgical tools. It offers higher precision, reduces complications, and promotes faster visual recovery.

3. What are intraocular lenses (IOLs)?

Intraocular lenses (IOLs) are artificial lenses implanted in the eye to replace the natural lens removed during cataract surgery. Made from durable, transparent materials like silicone, acrylic, or PMMA, most IOLs are UV-protected to shield the eyes from harmful rays.

Artificial lens used in cataract surgery. Source: Internet

There are two main types of IOLs:

Monofocal IOLs: Designed for a single focal point, typically distance vision.
Multifocal IOLs: Provide vision correction across near, intermediate, and distance ranges.

IOLs play a critical role in determining postoperative visual outcomes. Therefore, selecting the right type is crucial for achieving optimal results.

4. Monofocal vs. Multifocal lenses: A comparison

The terms “monofocal” and “multifocal” refer to the number of focal points supported by the lens.

Focal point refers to the eye’s focusing capability at specific distances: near (approximately 30–40 cm), intermediate (around 60 cm), and distance vision (over 100 cm). At each level of focal point, its function is distinguished:

Near: For activities like reading books, newspaper.
Intermediate: Suitable for tasks such as watching TV or cooking.
Distance range: For activities like driving or daily navigation.

To sum up, monofocal lenses define a single focal point whereas multifocal lenses describe the ability to have correction vision at multi focal points.

Table 4.1. A comparison of monofocal and multifocal intraocular lenses

Criteria	Monofocal IOLs	Multifocal IOLs
Features	Only for single focal point (near, intermediate, or distance vision), usually distance range is chosen.	Could be supported among three vision range: near, intermediate, and far.
Visual effectiveness	Sharp focus at one distance only.	Clear vision across all distances: near (30 – 40 cm), intermediate (60 cm), and distance (> 100 cm).
Advantages	– Lower cost. – Provides sharp vision at a single focal distance. – Ideal for individuals requiring clear distance vision, such as drivers or pilots. – Highly effective in low-light conditions (nighttime).	– No need for glasses after surgery. – Provides comprehensive vision improvement for patients requiring clarity at near, intermediate, and far distances. – Suitable for patients with cataracts accompanied by presbyopia or hyperopia.
Disadvantages	Glasses are required to support vision at other distances (near and intermediate).	– May cause glare or halos around lights, especially at night during the initial period after surgery. – Allows less light to enter the eye, making it unsuitable for patients with retinal conditions. – Higher cost.
Ideal for	– Elderly individuals or those with limited need for near and intermediate vision. – Suitable for patients with a limited budget. – Ideal for those requiring sharp vision at a specific distance, such as distance vision for driving or daily activities.	– Young, active individuals or those who prefer not to rely on glasses. – Suitable for patients with diverse visual needs in their work, such as office tasks, sewing, or cooking. – Ideal for individuals seeking optimal vision across all three focal distances.
Adaptation time	No adaptation time required.	Requires time for the eyes and brain to adapt to multifocal images.

Monofocal lenses are the most common used option in cataract treatment. With a single focal point design, these lenses are typically prioritised for distance vision. Patients using monofocal lenses experience sharp vision at long distances (over 100 cm) but need glasses to assist with near and intermediate distances, such as reading or computer work. This makes monofocal lenses a cost-effective choice for individuals with limited visual demands in daily life.

In contrast, multifocal lenses enhance vision across all three focal ranges: near, intermediate, and far. These lenses are particularly suitable for individuals with active lifestyles requiring versatile vision. However, multifocal lenses require an adaptation period for the eyes and brain to adjust to the changes in image processing. Additionally, they are more expensive and not recommended for patients with retinal conditions.

You should consult an expert when choosing cataract intraocular lenses. Source: Internet

Choosing between monofocal and multifocal lenses depends not only on the patient’s ocular health but also on their daily lifestyle needs and financial capacity. To achieve optimal treatment outcomes, it is essential to consult a reputable healthcare provider. Specialists will conduct a comprehensive assessment of your eye condition and provide tailored advice, helping you select the most suitable lens to enhance your postoperative vision quality.

5. Expert advice

Choosing between monofocal and multifocal lenses depends on several factors:

Lifestyle needs: Multifocal lenses are ideal for individuals who frequently engage in near tasks like reading.
Ocular health: Patients with conditions such as glaucoma or retinal detachment are better suited for monofocal lenses.
Budget: Multifocal lenses are pricier but provide convenience by reducing dependence on glasses.

Consulting an ophthalmologist is essential to evaluate your vision, overall eye health, and daily needs to ensure the best possible outcome.

6. Cataract treatment at Hoan My Gold Ky Dong Medical Centre

At Hoan My Gold Ky Dong Medical Centre, we take pride in being the exclusive provider of comprehensive eye care within the Hoan My Medical Corporation. With a highly skilled team, state-of-the-art technology, and patient-centred services, we are dedicated to delivering safe, effective, and personalised cataract surgery solutions.

The Phacoemulsification (Phaco) technique is the gold standard in modern cataract treatment. This procedure involves removing the cloudy natural lens and replacing it with an artificial intraocular lens, effectively restoring the patient’s vision. At Hoan My Gold Ky Dong, we prioritise safety and quality, adhering strictly to medical standards while continuously adopting the latest advancements in treatment techniques.

Moreover, we offer high-standard postoperative care services, ensuring patients achieve optimal treatment outcomes and satisfaction. Let your eyes be cared for and protected by a team of trusted specialists.

References:

HOAN MY GOLD KY DONG MEDICAL CENTRE
Hotline: 0919 209 039
Address: 27 Ky Dong, Ward 9, District 3, HCMC
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