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I had an accommodative lens placed in one eye. What are the ramifications if I opt to have a monofocal lens placed in the other eye?  

It depends on which type of accommodative lens you had placed and if you are happy with your vision in that eye.   

In the U.S., we currently have the Tecnis multifocal lens, the Restor multifocal lens and the Crystalens. If you have a Crystalens implant, a monofocal lens placed in the other eye is fine because it uses pseudo-accommodating effects which do not have a negative impact on vision if a monofocal lens is placed in the opposite eye.   

The other two multifocal lenses provide better quality of vision when they are implanted in both eyes since they both use diffractive optics where light is bent in different ways to provide near and distance correction. A monofocal lens in one eye and multifocal in the other eye can be performed but it sacrifices the advantages of both lenses and you run the risk of decreasing visual quality since each eye now uses a different optical system for vision correction. If you are not happy with the accommodative lens because of poor contrast sensitivity or decreased visual acuity, you may want to consider an intraocular lens exchange for a monofocal lens and then the second eye can easily have a monofocal lens. If you are happy with vision in the accommodative lens, it will give you better optics, better contrast and allow the eyes to work better if each eye has the same type of optical lens in place by having an accommodative lens placed in the second eye.

Answered by: W. Barry Lee, MDDr. W. Barry Lee

Categories: Cataracts

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Answered: Jul 10, 2012

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