Eye Health – Cataracts

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Dr S S Gill, Consultant Ophthalmologist

Ipoh Echo’s eye health series continues with consultant eye surgeon Dr S.S. Gill talking to us about multifocal intraocular lens implants during cataract surgery. The Multifocal Intraocular Lens (Multifocal IOL)

An intraocular lens (IOL) is an artificial lens that is implanted in the eye during cataract surgery as highlighted in the previous issue of the Ipoh Echo.  IOLs may be grouped simply as follows:

  • Monofocal IOLs – discussed in issue 131 of the Ipoh Echo
  • Astigmatism-correcting monofocal IOLs (Toric IOLs) – discussed in issue 132 of the Ipoh Echo
  • Multifocal IOLs (Presbyopia correcting) – discussed here
  • Presbyopia & Astigmatism correcting IOLs

In order to understand what a multifocal IOL is, you will need to understand a condition called Presbyopia. The word presbyopia comes from the Greek word presbys meaning “old man” and the Neolatin suffix opia meaning “sightedness”.

Presbyopia

It is the loss of the eye’s ability to change focus to see near objects usually starting around 40 years of age. This loss of power of accommodation to see near objects worsens with age. No one is really spared from this.

The first sign is often the need to hold reading material farther away in order to read a book. You can liken it to a ‘menopause’ of the eye!

Previously, after a person underwent cataract surgery, he or she would have to wear spectacles to read a book unless he is deliberately made short-sighted in which case the distant vision becomes compromised.

Now, with the advancement in IOL technology, we have presbyopia-correcting IOLs or multifocal IOLs. This would generally help a person see both far and near without glasses, therefore providing the comfort of “spectacle-freedom” most of the time or at least close to spectacle freedom for the daily chores.

Multifocal IOL

Multifocal IOLs are high-tech marvels. Most individuals have a good level of satisfaction when implanted with these IOLs. However, even though there is a high level of satisfaction, it is important to note that these IOLs may not produce ABSOLUTELY crisp vision at multiple distances at ALL times and in ALL patients! Even though the majority of people may not need any spectacle correction and enjoy spectacle-freedom, a small number may still require some spectacle help to read fine print. If you cannot accept this fact, then you are not a candidate for a multifocal IOL choice.

Another phenomenon with multifocal IOLs that you may have to be prepared for is the possibility of at least some glare and haloes around light sources at night. This may occur especially immediately after surgery. Nevertheless, these haloes and glare rarely prohibit night driving. They gradually reduce with time and most individuals do not see any haloes or glare by the end of 6 months if not all by the end of 1 year.

Generally, if you do not have any other eye diseases, you will most likely be satisfied with your vision by the end of 6 to 8 months.

As with anything of premium quality, Multifocal IOLs are about 2-3 times more expensive than a standard Monofocal IOL. Still, if you are a suitable candidate, the long-term savings you gain on the regular changes of reading glasses and multifocal spectacles would be well worth your investment.

Dr Gill will discuss more on cataracts & IOLs in the next issue of the Ipoh Echo.

For more information, contact Gill Eye Specialist Centre at 05-5455582, email: gilleyecentre@dr.com or visit www.fatimah.com.my.