Help my friend maximize her sight!

January 25, 2024 8:34 AM

A good friend (early 40s, female) has early onset cataracts in both of her eyes, and is getting surgery to remove them. Apparently she gets to make a choice between the replacement lenses she gets - multifocal or EDOF. Does anyone have any practical experience with this choice and what she should be considering? She's obviously getting advice form her doctors as well.

One of the lens options apparently allows her to see near and far better - a wider range of focus - but may have a halo effect at night and provide less crisp vision generally. The other would provide crisper vision and avoid a halo effect (which she gets with the cataracts and hates), but would require her to wear reading glasses for near vision.

She asked me to post this and would love any practical experience with this choice - is the glare/halo effect from the multifocal (I think) lens significant? Prevent driving at night? For the EDOF lens does it really prevent reading at all without reading glasses, or does larger font still work? What's the decreased image quality for multifocal versus EDOF?

Any good resources on this issue?

Thanks to everyone in advance!

posted by slide to Health & Fitness (9 answers total)

As I understand it, the best choice depends on whether your friend has presbyopia or not, and she should choose EDOF if yes, multifocals if not. But I am not a doctor of any kind, so please don't just take my word for this. I just happen to know someone who went through this surgery recently.
posted by MiraK at 8:58 AM on January 25, 2024

In an AskMe thread around a year ago, I wrote up a fairly detailed comment about my experience getting a PanOptix multifocal during cataract surgery, which I still like very much.

The halos from the PanOptix don't in any way prevent me from driving at night, and while I still see them, things have continually improved over the past year. At the end of the day, my own experience is that my vision is 20/20 and really very crisp and clear in most circumstances, and I'm not sure EDOFs or even monofocal lens would have resulted in any appreciable improvement in vision in my specific instance. However, everyone's situation is different because the conditions of all of our eyes are different; in my case, my surgeon was very enthusiastic about the potential outcome with the PanOptix, and they really seemed to be able to dial it in. (That being said, I would be very wary if my surgeon were not enthusiastic about the outcome.)

After cataract surgery, everyone loses near vision accommodation (and ends up with presbyopia) regardless of their age, so if the new lens itself doesn't have optics that support near vision (like the PanOptix does), they will almost certainly need to use reading glasses in some circumstances. Some people just don't mind reading glasses and would prefer to use them and not experience the halos a multifocal lens creates, others (including myself) resent the need for reading glasses or progressives as we age, and I would take the halo artifacts around bright lights of the PanOptix over having to go back to reading glasses any day.
posted by eschatfische at 9:25 AM on January 25, 2024 [1 favorite]

I too had early onset cataracts in my early forties. I did a lot of research at the time and decided on the more traditional EDOF lenses. Yes, I have to wear reading glasses to read, but that was starting to happen anyway as I aged, and basically everyone over 50 wears reading glasses, so I didn't see that as much of a negative. What really convinced me to not go with the multifocal lenses was that, from what I could tell, most eye surgeons offered the multifocal, but no one seems to enthusiastically endorse them. I could not find one instance of an eye doctor choosing them for themselves. The other option given to me was to have one eye's new lenses be for distance and the other for reading. In the end, I decided I wanted two eyes that both focus at a distance, particularly for driving at night. I wanted my nighttime vision to be a free of glare/halos as possible. Please take all this with a grain of salt, as my surgery was 15 years ago and the lens technology may have improved since then.
posted by juggler at 9:34 AM on January 25, 2024 [6 favorites]

If you’re ok wearing contact lenses, you could try multi- and single- focus lenses to see which you’d prefer. I’ve been wearing multi focal lenses for a bit and love them, but I do see halos while driving at night.
posted by u2604ab at 9:56 AM on January 25, 2024 [1 favorite]

Definitely MUST experiment with the multifocal contact lens, as u2694ab suggests. I did, just to see if I'd like to wear them (not ready for surgery yet), and they never worked for me. They say your brain will learn to look through the right part of the lens for near versus far vision, but it never happened. People vary. It was just like wearing single focus lenses that are a diopter too weak, for me.

Also, two of my local friends had bad results with the implanted multifocal lens. One had to have surgery again to replace it, which is vastly more complicated than getting the lens implanted in the first place; the other just resigned himself to not seeing well through that eye. But it apparently works great for others.
posted by metonym at 10:10 AM on January 25, 2024 [1 favorite]

As someone who has extreme astigmatism I would do just about anything to get rid of the halos. Like, seriously. It's getting to the point where I have a really hard time driving at night and I'm only just barely 53! If she already hates the halos, I can't imagine she'd be happy still experiencing that after surgery.
posted by cooker girl at 10:48 AM on January 25, 2024

There are a lot of relevant comments in this AskMe, which ended up not being about Lasik.
posted by The corpse in the library at 1:09 PM on January 25, 2024

I had cataract surgery about 5 years ago. I went with the surgeon recommendation of fixed long range (think that is what it is called, but knew I'd need reading glasses). I now have to use reading glasses, but I had already used glasses all my life. I just passed the eye testing at the DMV last fall with no glasses on. The good news is I can buy cheap $3 reading glasses, and sometimes don't even need them. Only bad thing is that my sense of depth perception is off after surgery. I pull into a parking spot and usually end up 3 feet or so short of where I expect to be.
posted by baegucb at 1:55 PM on January 25, 2024 [1 favorite]

I went the reading glasses route and don’t regret it a bit. Every professional I talked to said it was a better choice. Also they make a lot of cute readers and I have a wardrobe of them now.
posted by Peach at 6:47 PM on January 25, 2024