New lens choices
Binocular spectacle free vision (BSFV) often called “Monovision”
| Near and distance is in focus “BSFV” | Only distance is in focus (driving vision – need reading glasses) | Only near is focus (short sighted) |
Lens choice in summary
Any lens types give the chance of spectacle freedom and all lens types have possible side effects with glare, halos, shadows, arcs and light affects.
The following shows the likelihood of side effects for each lens option:
| Monofocal | 1% side effects |
| Torics | 2-10% |
| EDOF | 5-30% |
| Bifocal | 10-40% |
| Trifocal | 15-45% |
These side effects can be tolerated by many patients as they get used to them as the brain adapts to what it sees in most people, much as you get used to a new glasses prescription. However, this can take up to six months and may never happen, meaning you need another operation with all the same risks as the original cataract surgery.
Mr Radford uses monofocal lens, which can help people achieve spectacle freedom, though no one can guarantee this as biometry has an inherent error due to the final lens position. Research is ongoing to see if this can be better understood. Performing surgery separately allows fine-tuning of the biometry to maximise accuracy and the best outcome. Patients who choose a “premium lens” can find they do not like the side effects and opt to have the “premium lens” removed and monofocal lens used.
The biometry measurements give the power needed, but all biometry has an error margin, which is usually less than 0.5D, a small amount. Very rarely biometry is not as accurate and can have an error of over 1D. A lens may need changing. A lens may need changing.
New lens choices – real patient stories
If you have any concerns or questions about whether you should undergo surgery, it can be useful to hear the experiences of other people. IMPORTANT the stories below are from patients who Mr Radford heard from.
- A patient in his sixties, who was still working, found he was struggling with his vision. After visiting his optician, he discovered he had cataracts. As he worked using a computer, read lots and drove for business, he really wanted to be spectacle free after surgery. He researched and decided he really liked the idea of a multifocal lens so he would be able to carry out all his daily tasks without glasses. He found a surgeon and company who would do this for him privately and went ahead with surgery. Soon after surgery, he found he had problems with his vision experiencing halos and glare and still needed glasses to see clearly. His surgeon was dismissive of the complaints and the gentleman had to seek help elsewhere. He contacted Mr Radford for a second opinion. He was referred to a refractive surgeon for consideration of his options, which now meant lens replacement surgery with monofocal lens, free from excessive glare and side effects, or further refractive surgery with a laser to correct residual astigmatism and aberrations. Typically patients who do experience secondary effects from multifocal lenses are encouraged to get used to them over three to six months or even have their second eye operated on with the same lens to make the sensation the new normal visual perception.
- A lady in her late fifties found she had cataract and paid for a private consultation. It was recommended that she had a new technology called EDOF, meaning ‘extended depth of focus’ lens. She was told that this new lens had no side effects like a multifocal and guaranteed 100% satisfaction. She was delighted with this and went ahead, but soon afterwards she experienced new symptoms of discomfort with bright lights and glare. She was told she would get used to it, but she did not. Seven months after the initial surgery, she asked to have the EDOF lens removed and a monofocal lens was put into her eye instead with complete cure of the problematic symptoms.
- A man in his seventies, who was a keen golfer, had bilateral cataract surgery after having had LASIK laser eye surgery only two years before. He opted to have multilfocal lenses as he was assured these would likely give him freedom from glasses and the ability to drive, play golf and read easily. After surgery, he had nighttime glare, his refraction was unstable and he needed glasses also.
- A retired lady had bilateral cataract surgery with monofocal lenses on the NHS pathway. She wanted to read and drive without glasses if possible. She had been short-sighted in the past and always read without glasses. She had surgery with monofocal lenses, with her dominant eye made distance focused and her non-dominant eye made near focused. After surgery, she could easily drive and read without glasses and was free from any side effects of the lens. Six years later, at a check-up for other reasons, she confirmed her vision was still wonderful and no glasses were needed.
- A self-employed man found he was struggling to read and driving at night was an issue. He did not want to wait for NHS treatment so found Mr Radford on the internet and made an appointment to be seen quickly, Within a few weeks, he had undergone surgery on both eyes with monofocal lenses and could now do all his work and drive without the need for glasses.
