Ask an Eye M.D. Answer Archive

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Question:
I have the beginning of a cataract in my right eye, and a macular pucker in the left eye. My surgeon has suggested getting both eyes done (for cataracts) and replacing the lens with "normal" lenses requiring me to still need reading glasses. Is this the best option? He said my macular pucker would prevent multifocal lenses from working for me. Do you agree? Would doing one eye for distance and one eye for near sight work?

Answer:
I agree that a patient with a disorder of the macula should avoid diffractive intraocular lenses, like the ReStor or the Tecnis MF. These lenses divide the light passing through the IOL into a distant and a near focus in such a way that the macula never gets 100 percent of the light entering the eye. A compromised macula will likely be unable to provide highest quality vision. The Crystalens does not divide the light that enters each eye into a far and a near focus, but functions by moving light forward or backward in the eye with the effort of focusing. Some have faulted this lens for not having sufficient near vision potential. Monovision is attained by placing a distance focusing lens in one eye and a near focusing lens in the other eye. This works well for many people, but in the presence of macular dysfunction, may lead to unhappiness with the quality of vision in the compromised eye. I agree with your ophthalmologist (Eye M.D.) and suggest standard monofocal IOLs set for distance in each eye as being your least risky choice.

Answered by: Wayne Bizer, DODr. Wayne Bizer

Categories: Cataracts, Eye Surgery

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Answered: May 21, 2013

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