I wanted to do this. But I was not a candidate for this type of lease at all (glaucoma). But the folks I know who got these have been happy for the most part.
Yes, I had the multi-focal lense (I believe the full name is “multi-focal inter ocular lenses (IOLs)”) replacement in both eyes. I’m reluctant to call it Lasik surgery because I think that is a very specific procedure that has to do with reshaping the cornea.
I’ve got my appointment with my ophthalmologist set for mid November. Like you I’m nearsighted and have worn glasses most of my life. I’ve had transition lenses and have loved not having to worry about whether or not I’ve remembered my sunglasses. I’d miss that. I have dedicated sun glasses for beach wear or cycling etc. I’m pretty sure I’m going to go with option 2 and keep my transition lenses. My right has gotten much worse in the last year. I was told by my optometrist last year that they couldn’t improve the vision in that eye with glasses anymore. At the time it was not considered bad enough to get cataract surgery. I had to renew my license this year and when I took the eye test I couldn’t read the top line with my right eye (left eye I could read the bottom line with no problems). I can’t wait to get this done. Frankly I’m hoping that I can get rid of the bifocals too. I have an astigmatism so I might have to pay extra for the toric lenses.
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I had a thread on this topic a few months ago that you may find helpful (link below to first post). I am just over 2 months out from the second eye and my light sensitivity continues to get better. Some days I don’t notice any now. Eye doc said it could take up to 6 months for full recovery in terms of the light sensitivity. My vision wasn’t that bad before the surgery, but the best way I can describe improvement is that I could read the scores during tennis matches (summer hard courts & US Open) on the tv without glasses or moving closer. Good luck!
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Multifocal IOLs, due to the nature of how they work, create halos, glare and starbursts, primarily at night. They are getting better, but based on the optics, it’s still a universal phenomenon. Everyone with a multifocal will experience it. A few are bothered to the point that they require explantation, not an easy task if any significant time has passed.
When we’re young, we see up close through accommodation, physically changing the shape of the natural lens to make it rounder and more powerful. It’s an elegant system that unfortunately fails us as we age.
Intraocular lens implants cannot do this. Crystalens attempted to mimic accommodation, but it didn’t work. Enter multifocal IOLs.
They work by having many rings of different focal points, typically far, intermediate and near. They’re now blended better, but essentially at all times some of the light is focussed at a distance you’re not concerned with. If you’re driving, some of the light is focussed for reading. If you’re looking at the computer, some of the light is focussed at infinity. The result is images that aren’t perfectly focussed.
This is more of an issue at night as the pupils dilate and expose more of the rings.
Astigmatism, the phenomenon where light doesn’t bend to one point like it does in say a magnifying glass burning leaves (in the most simple terms, a point of light is focussed into a line rather than a point), is relevant because IOLs in the past did not correct for it. There are ways now to compensate for that. Toric IOLs, light adjustable IOLs and LASIK (reshaping the cornea) are all options.
Most patients are happy. It’s just not the same as being 20 and glasses free again.
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I’ve read the same thing, but it hasn’t been a noticeable thing with me. Probably because I don’t spend a lot of time driving at night.
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I had cataract surgery 18 months ago. I was extremely nearsighted with pretty bad astigmatism. I had used progressive lenses for my glasses and had contacts set with monovision. I wore glasses for 60 years.
Opted for IOL (Tecnis Synergy lenses) which was the most expensive option but so worth it!
No glasses at all. No readers. I experienced just a bit of glare around street lamps at night but that has disappeared. I couldn’t be happier. Eventually I may need glasses again but for now I’m super happy to be done with them. They keep advancing the lenses.
My research on lenses was “after the fact”–the doctor chose them. But there are differences between the brands. The Tecnis Synergy had less chance of glare than some others.
The IOLs are sort of like progressive lenses–if you’ve tried them you know there is a “breaking in period” where your brain has to get used the sensations like going down stairs while looking through the wrong part of your lens. Same with monovision in contacts (one eye far and one close)–the brain adjusts and then it all seems normal but at first it can be disorienting.
If you’ve already had progressive lenses or tried monovision with success then you’re good to go. You know your brain will adapt. The trick is that 20 percent or so of people do NOT adapt so IOLs or monovision options would be terrible for them.
I used eye drops for quite a while afterwards but have no need for them now. Doc said the haloes around lights may appear but usually fade in 6 months to a year (or never–no guarantees unfortunately)
Definitly agree on the paint colors! The whole world is so bright and colorful! I had painted some bedrooms and was disappointed in the color of one–thought it was too dark–turned out it was my eyes–I like it now!
The optics mean it’s a certainty, but many don’t notice, and only a few are bothered to the point they have them removed.
It’s probably because most people experience some form of halos, starbursts and glare from their cataracts and the resultant aberration is less with multifocal IOLs. So, even though they aren’t eliminated, they are less bothersome.
I bring it up simply because it’s a challenging thing to comprehend, and too often sold as a panacea. For some it is, but dissatisfaction is the second leading cause of IOL explantation behind decentration.
There is a middle ground, but in general, those who love them, really love them. Those who don’t, really don’t.
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It is for me!
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They are different. One does not predict success with another across any of those modalities, other than to suss out vision perfectionists who aren’t really candidates.
It’s not IOLs per se that aren’t a great idea for vision perfectionists, but rather multi focal IOLs.
Brands differ. There isn’t a “best”. PanOptix, Synergy, Symfony, Vivity, etc. all have their place. Clinics tend to be brand loyal, but that’s based on many factors, including cost. Choosing the right multifocal is ideally, but infrequently done after a nuanced conversation about goals and dislikes.
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They may have their respective places but some appear to be heads and tails better than others after reading about different ones.
And sorry I disagree–knowing your brain can make that jump is important in having any confidence to try toric.
It’s getting technical, but it’s not. If I could show you your best corrected vision at 20 and your best vision now with a multifocal, you would notice a difference. The 20 year old, unaltered eye would have higher contrast sensitivity and lower aberration. What you have now approximates that result close enough that you, as an individual, are very happy, and that’s all that matters.
The take home message is that isn’t a universal experience. I’ve seen thousands of cataract post-ops, hundreds of them with multifocals. The majority are happy with their choice, but a small minority are pretty unhappy, usually due to something that could have been sussed out pre-operatively in most cases.
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What factors pre-op would point to someone who should not do multifocals?
(and my vision at 20 was terrible too so I’m better now. I’ve worn glasses since second grade and probably could have used them sooner…)
Choosing a multifocal lens is a matter of balancing range, clarity and glare. Do better at one, and you do worse at another. When discussing lens options with patients it is a matter of sorting out which of those is a priority, and what they’re willing to compromise. When patients say they are extremely intolerant of night glare, we push them away from multifocals. Also, if they are vision perfectionists, meaning only tack sharp vision is acceptable at all ranges, they are dissuaded from pursuing multifocals or LASIK. That’s not because that result isn’t possible, but because their dissatisfaction would be so high if it wasn’t achieved.
When discussing your 20 year old vision, I don’t mean without correction. I mean best corrected visual acuity.
Many people, probably most people have smaller refractive errors after any type of IOL is implanted. We tend to talk in terms of best vision though, not uncorrected vision. It’s when tack sharp, uncorrected vision is the expectation that we can get into the weeds. The standard deviation in cataract outcomes is much higher than glasses, contact lenses or LASIK.
Again, what is a successful and happy outcome will differ from patient to patient.
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Calling Marcel Proust! 
@eyemgh THANK YOU so much for your patience and kindness on this topic. It’s been so helpful to me.
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I have driving glasses that have an anti glare coating that has reduced the flare and halo effect. Ask your dr about that if concerned about mulifocal issues.
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Are you an OD, MD? Sounds like this is definitely your field. Thank you fir all this help. It lets me be a bit more educated when I finally speak with the surgeon.
I’m a Hospital Based Residency Trained OD who was the highest volume provider in the busiest ophthalmology practice in the region for over 20 years. There’s not much I haven’t seen and managed. 
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This is so nice of you to educate us. Thank you.
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