With a standard monofocal lens implant, the vision will be very clear in the distance but very blurry up close (for reading) without glasses. Some patients have even complained that they could not see their food at the dinner table without using reading glasses. Multifocal lenses were developed to allow patients to see well at several distances WITHOUT GLASSES after cataract surgery. Multifocal lenses offer benefits above and beyond those of standard lenses but are more expensive than standard lenses.
Eye diseases, such as glaucoma, diabetic retinopathy, diabetic macular edema, or macular degeneration, can negatively affect the health of the eyes and the quality of the vision. These diseases, even in early stages, could cause problems with premium lenses.
A multifocal lens is not recommended if you have one of these eye diseases:
Astigmatism is an irregular curvature of the cornea. Instead of being round like a basketball, the cornea is shaped more like a football or a spoon. Patients with moderate astigmatism are therefore not good candidates for a multifocal lens.
Visual needs should also be considered when deciding on a multifocal lens. The technology contained in these lenses that allows you to read without glasses may lead to mild symptoms such as glare, halos, or decreased contrast sensitivity in certain conditions, such as night driving or dim restaurant lighting. Some patients rarely notice visual effects related to the lens implant. Others notice the effects but are not significantly bothered by them. If you feel you would not be able to adapt to these visual symptoms, you probably are not an ideal candidate for a multifocal lens.
Motivation to not wear glasses should also be determined when selecting a multifocal lens. These lenses are designed for patients who are motivated to not have to wear glasses after their cataract surgery. Some patients are accustomed to wearing glasses and do not mind using them after surgery. The additional cost of a multifocal lens would not be a reasonable investment for these patients. For other patients, eliminating the need for glasses is a strong desire. Paying the additional out-of-pocket cost for a special lens would make much more sense for these patients, as these lenses would give them the best option to achieve their goal to be free from glasses.
In summary, ideal candidates for multifocal lenses are patients with healthy eyes, little to no astigmatism, motivation to be less dependent on eyeglasses or contact lenses, and willingness to adapt to minor visual effects from the lens. Patients selecting a multifocal lens can reasonably expect to have good vision for reading and driving. Because no current technology is perfect there may still be circumstances where glasses are required to achieve comfortable vision.