I use an aspheric (toric if necessary) monofocal IOL. With a unilateral cataract, the visual quality from a multifocal IOL will be noticeably poorer than the unoperated eye, with lower contrast and halos. The multifocality can never match the good eye in a young patient, so at least a monofocal gives perfect binocular vision for distance. Still it is important to counsel the patient since different patients have different priorities.
Despite not being a clnician, I agree to Yong Ming.
I would propose the use of an aspheric (toric if necessary) monofocal IOL counterbalancing corneal spherical aberration as to get theoretically +0,1µm of SphAb (~6mm pupil size) in the whole eye. With a unilateral cataract, the visual quality from an eye potentially implanted with a multifocal IOL will never match the quality of the unoperated eye.
An properly selected aspheric (eventualy toric) monofocal gives will provide similar quality between eyes for distance vision. For near, the patient will necessarily depend on the unoperated eye (and achieve monocular near vision).
The new segmental bifocal MIOLs have contrast sensitivity levels similar to a 30 y old with no cataract and the dysphotopsia levels are very small. The full refractive and diffractive MIOL are different
A question to Sunil:
Again, I am not a clinician, so excuse me if my question is too stupid.
Provided that as you mentioned "the new segmental bifocal MIOLs have contrast sensitivity levels similar to a 30 y old with no cataract and the dysphotopsia levels are very small", would you implant in a "regular" cataract patient (say 63 years old and bilateral cataracts) a +3D MPlus from Oculentis (toric if necessary) in one eye (say the near eye) and an aspheric (toric if necessary) monofocal IOL counterbalancing corneal spherical aberration as to get theoretically +0,1µm of SphAb (~6mm pupil size) in the other eye (say distance eye) to get close to perfect far vision with almost full binocularity and "more than sufficient" near vision monocularly in the near eye?
If no, why not?
Thank you in adavance and I appologize to Jaidrath Kumar for misusing his thread.
Sorry again, I placed my question openly to better understand your positions and their rationale (no to offend you or putting a question mark to your comment), just because my mom (63 years old and bilateral cataracts) has just been operated for cataracts and all 3 well-known surgeons rejected implanting their diffractive MIOL of choice (bifocal in one case, trifocal in another case, and anodized in the third case) in one eye (say the near eye) and an aspheric monofocal IOL counterbalancing corneal spherical aberration as to get theoretically +0,1µm of SphAb (~6mm pupil size) in the other eye (say distance eye) to get close to perfect far vision with almost full binocularity and "more than sufficient" near vision monocularly in the near eye.
And this despite their promise of "very good contrast sensitivity levels similar to a 35 y old with no cataract and low to no dysphotopsia levels", so i understood between-the-lines that the visual quality from the multifocal IOL would be noticeably poorer (with lower contrast and halos) than the aspheric monofocal implanted eye, and that in essence the multifocality could never match the aspheric monofocal implanted eye.
Thank you again.
no need. I normally place a +1.5D in dominant eye and +3D in non dominant eye
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