Patients often are drawn by the financial savings of pseudophakic monovision with conventional IOLs compared with multifocal IOLs. H., Mc Donald Eye Associates, Fayetteville, Ark., who uses monofocal IOLs for monovision and a mini-monovision approach with the crystalens for patients who would like to depend less on glasses.
"When we're counseling patients preoperatively and they want to reduce their dependence on glasses, a lot of it comes down to financial considerations," says Chad Betts, M. Furthermore, many surgeons like using monofocal IOLs because of the better results they obtain with them.
FDA-approved IOLs have been available since the early 1980s.
Before the use of intraocular lenses, if you had cataracts removed, you had to wear very thick eyeglasses or special contact lenses in order to see after cataract surgery, since no device was implanted in the eye to replace the focusing power of the natural lens.
This shows the quality of near vision obtained with a range of near outcomes, mostly arranged around the -1.50 D goal and the importance of hitting the "distance" target eye at plano to - 0.25 D, allowing for better adaptation to monovision. "In my experience 70% of our cataract patients — and it's varying a little bit with the economy — elect to have presbyopia correction with their cataract surgery," Dr. "That's very high." He also performs clear lens extractions in appropriate cases. Betts' office offers patients a questionnaire with a focus zone chart developed by Dr. Patients are asked which zone — ranging from newsprint to movies — is most important to them. If a patient is most concerned about computer vision and golf, Dr. S., clinical assistant professor of ophthalmology, University of Hawaii School of Medicine, Honolulu.
However, some patients may need a permanent change. Gills says approximately 10% to 20% of people cannot adapt to monovision and some may require a lens exchange or refractive surgery. "This helps you to better tailor your selection based on a patient's visual needs," Dr. The questionnaire also asks whether it is important to them to reduce their dependence on glasses. Betts explains that he can select a monovision approach that will reduce the need for glasses for those tasks but stresses the tradeoff — that glasses will be needed for close reading. Betts also asks about the patient's occupation. He says these types of patients generally are not good candidates for pseudophakic monovision, as well as surgeons, engineers, accountants and other professionals who require perfect binocular vision for distance and near. Maloney says occasionally a patient's personality may not be suited for pseudophakic monovision.
Consider premium IOLs to restore the quality eyesight you had when you were younger, as well as your quality of life.In addition, "when compared to pseudophakic monovision, I feel uncomfortable with the leap of faith that is required with multifocals," Dr. "There's no way I can tell whether a patient is going to neuroadapt to this multifocal image or not, whereas with pseudophakic monovision I can predict with a high degree of accuracy his adaptation and tailor an approach that remains well below his threshold of acceptance." Some surgeons prefer pseudophakic monovision because it can be reversed temporarily with contact lenses or glasses if patients are taking long driving trips or if they have difficulty adapting."That's an advantage that I think is really appealing to a lot of surgeons as opposed to multifocals, because if you're having symptoms of waxy vision or some glare, that's not correctable very easily with glasses or a contact lens," Dr. Figure: Top graphic shows a defocus curve example of how a 20/40 letter E appears through a 3-mm pupil with the "distance" plano eye; the bottom graphic represents the "near" eye set at -1.50 D. Maloney offers pseudophakic presbyopia correction to all of his cataract patients, explaining that they may or may not be candidates for one approach or another. Counseling the patient and determining his or her needs is very important with pseudophakic monovision and premium lenses because everyone has different needs, Dr. For example, a patient who works on computers 10 hours a day will have different needs than someone who spends a lot of time reading books.The procedure usually takes less than 20 minutes, with a recovery period about 2–3 weeks.For several months after the procedure, patients will need to visit with Dr.