For Patients: Is Correcting Presbyopia During Cataract Surgery a Good Idea?

Presbyopia is the loss of ability to refocus from distance to near.

With cataract surgery, you have the opportunity to treat presbyopia with multifocal and extended depth of focus intraocular lenses. The multifocal lenses (MF) have two different focal points; distance and near. The extended depth of focus (EDOF) lenses provide a broader depth of field. These lenses have similar functions and side effects, and will be discussed together using the term MF/EDOF lenses.

If you are considering a presbyopia correcting lens, consider the following:

The focus is still on distance: MF/EDOF lenses are distance dominant; meaning that more focusing power is given to your distance experience. Reading fine print may be difficult in some cases, even with these lenses.

Consider side effects: The MF/EDOF lenses do everything well, but not perfectly. With these lenses, you will experience at least some of loss of contrast, glare, and halos at night. The very best distance vision, the purest image with the best color and contrast, absent any distractions, will be achieved by the single focus lens you already get through your insurance.

Are side effects of presbyopia correcting lenses OK with you? Vision is subjective. What one person perceives as disabling glare may be a tiny distraction to another. Think of who you are. If you are on the mellow side, generally happy and satisfied with things, you are more likely to look past the minor side effects of multifocals and enjoy their benefits. If people tell you that you are difficult to satisfy and very particular, you might be quite bothered by these things.

Is treating presbyopia really important to you? Do you really care if you have to have a pair of readers dangling about your neck? Some people do, others don’t. Some surgeons care more about this than others. What really matters is how much YOU care.

Do you have the right eyes? Your exam may reveal reasons to think twice about MF/EDOF lenses. These can include dry eyes, astigmatism, imperfections in the fovea, and glaucoma.

In summary, MF/EDOF lenses are good but not perfect. They work great if you have the right eyes, attitudes, and goals. There is much more information on presbyopia correcting lenses and other presbyopia correting strategies on my website. Click here for a more detailed discussion of presbyopia correcting lenses, and here to to see a presbyopia correcting lens simulator.