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The best intraocular lens: How to choose?

In the surgical treatment of cataracts (clouding of the lens), one's own lens is removed, and an artificial lens, called an intraocular lens or IOL, is implanted in the eye.
There are different types of intraocular lenses, the patient needs to choose which one is best for him.

How do you know which intraocular lens is better?

  1. Monofocal Intraocular Lenses. Monofocal lenses are used to restore vision for a single area of focus. At the same time, the quality of vision at the focus point is obtained as high as possible and, as a rule, does not depend on lighting. These lenses are usually used to restore vision in the presence of concomitant eye pathology – diseases of the retina, optic nerve, glaucoma. After surgery to replace the lens with a monofocal lens, glasses will most likely be required.
  2. Multifocal Intraocular Lenses.Multifocal lenses improve vision at different distances: they correct vision in the distance, near and between them. Multifocal lenses allow you to improve vision at a certain distance, taking into account the patient's lifestyle. Multifocal lenses were created to improve monofocal lenses and traditional cataract surgery techniques. Previously, restoring vision after surgery was the main task. Patients had to wear special glasses to restore focus. Multifocal lenses are divided into diffractive, with many small rings that allow you to see at different distances, and progressive, with a smooth transition of vision into the distance and near. The diffraction design is less dependent on the condition of the cornea and the presence of slight astigmatism, while progressive lenses provide better vision up close at dusk and into the distance in bright light. For many, multifocal IOLs are the right choice if it is important to improve vision at a distance and up close without glasses, but at the same time, there may be a lack of vision quality in poor lighting conditions. 
  3. Toric Intraocular Lenses. Toric intraocular lenses are lenses that correct not only astigmatism, but also nearsightedness or farsightedness. They can help restore clear vision with severe astigmatism and cataracts.The advantages of a toric IOL are similar to those of a monofocal lens: they allow you to see better at a distance or when reading, but not at both distances.

How to make the right choice?

The surgeon can help determine which IOL is more suitable for the patient. There is not a single IOL that is the "best" for everyone. It all comes down to finding the optimal solution to meet the specific needs of the patient. A doctor may even recommend mixing two different multifocal lenses or two different types of IOLs.
The patient's needs are determined by his daily activities and what kind of vision is of primary importance to a person. To be as satisfied as possible with the quality of vision after surgery, it is necessary to formulate your needs as clearly as possible.
If it is extremely important for a person to have good distant vision, because he likes to spend time traveling, or his profession involves the need to look into the distance. Does the patient object to wearing reading glasses or computer glasses after surgery? Is it possible to compromise in order to have better vision at a distance? Each intraocular lens has its own set of advantages and limitations. These points will help the surgeon understand the patient's needs in order to choose the best IOL for him.
Patients with glaucoma, macular degeneration, corneal disease, or other conditions require a specific type of lens. The ophthalmologist will take into account all these conditions and the general health of the eyes and recommend the most appropriate lens during the examination and consultation.
 

The author of the material is ophthalmologist-surgeon Natalia Bosha
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