What are the best replacement lenses for cataract surgery?

The intraocular lenses used for cataract surgeries can be roughly divided into 2 main groups: mononofocal vs multifocal.

Monofocal lenses have only one focusing plane, while multifocal lenses have different focusing zones with different focusing power, to allow one to have good vision at more than one distance in the same eye. Some of the newer multifocals also go by descriptions like extended range lenses.

Both mono and multifocal lenses can incorporate astigmatic correction if needed. Significant uncorrected astigmatism (astig is called 散光）contributes to blurring at all distances.

In most clinics, the standard lenses are monofocal, non-astigmatic correcting, which can already correct short and long sightedness quite well. However, some degree of residual refractive errors are expected after the cataract surgery, and generally your grandma will expect to have to wear glasses at least some of the time.

Premium lenses such as astigmatic-correcting and multifocal on the other hand should be able to provide better uncorrected vision. If your grandma hates wearing glasses, she may benefit from exploring some of these "premium lense". The exact type, design and brand of the lenses will also depend on the state of health of her eyes.

The process of making a decision to have surgery can be fraught with information overload.

Having cataract surgery and its myriad options is no exception. To be clear, there really isn’t such a thing as the “more recommended” lens implant used during cataract surgery. Understand that the primary aim of any cataract surgery is first and foremost to replace the natural lens that has turned cloudy and replacing it with a new clear artificial lens implant. In that respect, the majority of lens fulfil that objective well.

Where choices are to be made about implants are when the patient has to decide if being spectacles independent is an important goal for the patient. If the patient is happy wearing spectacles, then a monofocal lens implant would be a great choice.

Alternatively, if the patient is keen to use cataract surgery as an opportunity to additionally see the world without glasses, then multifocal lens implants may be considered.

Bear in mind that not everyone is suited for multifocal implant lens. It is important to undergo a detailed eye examination and to have your surgeon thoroughly explain the pros and cons of each lens implant choice.

There is no single ideal lens that is will be suitable for all patients's eyes.

In general, patients will have choice of either single vision lenses or multifocal lenses. The choice will depend on:

• The patient's age
• Current spectacles prescription
• Patient's retina condition
• Patient's expectations, etc.

In my opinion, it will be best for your grandmom to discuss the options with her own eye surgeon, as the surgeon will know her eye condition best.

I hope that this is helpful to you!

Yours Sincerely,

Dr Tony Ho

There are many replacement lenses for cataract surgery available to patients in Singapore.

The broad categories include:

• Multifocal lenses (includes bifocal and trifocal lenses)
• Extended range of vision lenses
• Monofocal lenses

The choice of which category of lens to implant is probably the most important factor, and this would involve a careful and detailed discussion of your requirements with your attending ophthalmologist, as each category of lenses function differently and give the patient flexibility of vision whilst making compromises in other areas.

In general, multifocal lenses and extended range lenses give the patient clear vision at different distances including near, intermediate and distance (with a minor compromise in visual quality and side-effects of glare and haloes during dim lighting conditions).

This is in contrast to monofocal lenses which give unrivalled visual quality at one distance only ( hence patients are often given a combination of near / intermediate distance vision for each eye in order to give excellent intermediate and distance binocular vision without sacrificing visual quality).

For full details and a tailored solution for your individual needs, you are highly encouraged to speak to your attending ophthalmologist for a bespoke solution to your needs.

Briefly, the various types of lenses available include:

1. Monofocal lens — targets good vision at a chosen distance

2. Toric lens — corrects astigmatism

3. Multifocal lens — targets far and near vision

4. Trifocal lens — targets far, intermediate and near vision

5. Extended depth of focus (EDOF) lens — gives an extended range of vision

It is true that there is NO such thing as a best lens when comparing all of the above.

There is however, a best choice for each individual, depending on the individual’s visual requirements, daily activities and personal preferences.

A detailed consultation with the eye doctor will be able to elucidate which lens is best for your grandmom.

At the same time, each type of lens has their pros and cons; these should also be discussed before considering which lens is best for her. I hope this was helpful to you.

Yours truly,

Dr. Claudine Pang