I have just read up on another IOL called ‘MEDICEM WIOL-CF Accommodative Polyfocal IOL’, that works similarly to a natural lens and shaped the same. Reading the information, it covers all range of distance from near to far, with the only need for glasses for fine near vision. But there does seem to be less ability to accomodate in older age and hence focus as well. Not sure what that translates to in respect to these types of lenses working.
It appears to solve the low light and contrast issues as well as dysphotopsia issues. I am in Thailand and not sure if or who would use this IOL and if it is even approved here.
But from reading it, this lens seems to be much closer to what an artificial lens should be like, compared to the flat lens and concentric rings on trifocals and EDOF IOLs.
https://swissmed.asia/shop/intra-ocular-lenses/medicem-wiol-cf-accommodative-polyfocal-iol/
Anyone heard of this?
I have PanOptix trifocals in both eyes… Based on what you have reported, I think you may be happiest getting the trifocals. That’s the best way to be reliably “glasses free”. The lenses DO produce halos around bright lights at night… but I have found this effect to be unremarkable, not the sort of thing that bothers me. Tho… perhaps it may bother you. I don’t know
An EDOF by definition (and ironically) will have a shorter depth of field compared to a trifocal, and you will probably need glasses for close reading. Some people choose to under-correct one eye so that one eye sees closer than the other… and the blended vision helps them avoid glasses. I haven’t done that, so I can’t comment… except to say that I considered and rejected that option, and chose PanOptix trifocals.
Hello,
I don’t know if this helps or makes things more difficult. I was on this forum a while ago trying to make the same sort of decision as you. I had pretty much decided to go with the AT Lisa, when the pandemic hit and cataract operations were halted (in the UK). I used this to reconsider my options, as I had also wanted to find a way to avoid glasses.
During this time, my surgeon retired and passed my files to a colleague - I know someone who works in their practice and so I have now managed to get the ‘free’ opinion of five surgeons in addition to the original. Four of the five said they would never choose anything for themselves other than a monofocal. The various reasons they gave ranged across: night-time glare and halos, as pretty much a certainty; loss of contrast sensitivity, particularly in low light; no guarantee that you will avoid glasses; less clarity and less ‘quality of vision’ - this last one confused me because when I brought up the studies that show comparable results, they said that with trifocals or EDoF lenses you find that the clarity is not as good, and that while you may have very good scores using an eye-chart this doesn’t necessarily transfer to daily living. The one surgeon who was happy to use trifocals agreed with all of this, but said that after having cataracts all lenses were an improvement. (Which is not really a ringing endorsement.)
So, now I find myself leaning more towards the monofocal - to add to the confusion both my brother and a good friend had monofocals implanted just before the pandemic, and both are really happy with the outcome. In fact, only today my brother’s surgeon actually told him he made the right choice going for a monofocal due to the number of trifocals she has explanted.
Of course, everyone’s experience and needs are different and I believe that all the lenses are probably very good in the right situation. I don’t want to take away from any of the forum members who have recommended other lenses, some of whom were very generous with advice to me early on - but I do think it is worth noting how many eye doctors - in my limited circle - think that the potential benefits are not worth the potential downsides.
Anyway, long post to say that it might be worth considering the monofocals - and I say this as someone who desperately wanted the trifocals to be the right choice for me.
Hello Peter,
did you make a decision in the meantime?
I have trifocal ZEISS LISA in both eyes. Surgery was one year ago. Didn’t wear glasses since childhood (contacts only) but now have to wear several pairs of glasses all the time. In addition severe dysphotopsia which means huge contric rings and spider webs around point light sources that impair my night driving ability. They didn’t decline. Glare even increased. I got floaters because of the surgery and other unwanted issues. One should know that in 73% of the cases they don’t hit the refractive target. I am one of those 73% with significant residual astigmatism left in both eyes. If you don’t need toric IOLs, than it’s easier because rotation of the lenses does not apply to you. Despite second surgery with rerotation both IOL are still off-axis. Maybe this also increases my dysphotopsia. Laser treatment won’t help with this. The refraction error can be fully corrected with glasses but with laser it’s unsure. In addition laser will cause dry eyes. My eyes have already suffered from the surgeries. Contacts are therefore no longer possible.
The ZEISS lens is not good for demanding computer work because it has deficiencies in the intermediate range. The lens also doesn’t provide seemless vision, there are gaps. In my case I need +1 reading glasses for laptop work and +2 reading glasses for closer reading and handwriting. Be aware that varifocals are not possible after receiving trifocal lens implants. Therefore I have to put the reading glasses on top of my far specs which I need to correct the residual astigmatism.
Of course you can be happy with your outcome but refractive surprises can always occur. Diffractive optics means dyshotopsia, it’s physics. But they differ individually in size and brightness. You will loose contrast. To give you an example what this means: Before the surgery I was able to read the street names on the other of the road (4 lanes) while driving at night in the city. That’s no longer possible.
So far my experience.