Can Multifocal Intraocular Lenses Improve Vision with Macular Degeneration?

Postoperative visual acuity remains at 0.4-0.5 with multifocal intraocular lenses for cataract surgery?

My mother is 74 years old and has been experiencing dry eyes with frequent tearing.
In recent years, she has noticed increasing blurriness in her vision.
After consulting several doctors, she was told that her cataracts were not mature enough for surgery, so she was prescribed reading glasses.
Recently, another doctor assessed her condition and determined that the cataract in her right eye is now mature enough for surgery.
She underwent multifocal intraocular lens surgery on July 27, 2021.
During her two follow-up visits after the surgery, her vision was measured at 0.4 or above.
The doctor mentioned that macular degeneration could affect her recovery time.
Another surgery for her left eye is scheduled for August 17.
However, she is worried because her vision in the right eye has not improved, and the doctor indicated that the condition of her left eye is worse than the right.
Currently, her left eye, which has not yet undergone surgery, shows improvement when using reading glasses for near vision.

I would like to ask the doctor:
1.
Is it possible to achieve vision improvement with multifocal intraocular lenses in the presence of macular degeneration?
2.
Given that there has been no progress in the right eye, is it appropriate to proceed with surgery on the left eye? If surgery is performed, should multifocal intraocular lenses still be chosen?

A-FANG, 40~49 year old female. Ask Date: 2021/08/05

Dr. He Jianxian reply Ophthalmology

1.
If the macula is severely degenerated, the results of any type of intraocular lens will not be ideal.
2.
If you have concerns, the surgery can be postponed, as it is not an emergency procedure.
Regarding the intraocular lens, a multifocal lens is generally a more favorable choice, especially since a multifocal lens has already been implanted in the right eye; typically, the left eye would not be fitted with a different type.
Dr.
Ho Chien-Hsien, Department of Ophthalmology, Nantou Hospital.

Reply Date: 2021/08/05

More Info

When considering the use of multifocal intraocular lenses (IOLs) in patients with macular degeneration, several important factors need to be taken into account. Macular degeneration, particularly age-related macular degeneration (AMD), is a leading cause of vision loss in older adults. It affects the central part of the retina, known as the macula, which is crucial for sharp, central vision needed for activities like reading and driving.

1. Impact of Macular Degeneration on Multifocal IOLs: Multifocal IOLs are designed to provide clear vision at multiple distances, which can be beneficial for patients who wish to reduce their dependence on glasses after cataract surgery. However, in patients with significant macular degeneration, the effectiveness of these lenses may be limited. The underlying retinal condition can affect the quality of vision, and even if the multifocal IOLs are functioning as intended, the patient may still experience blurred or distorted vision due to the degeneration of the macula. Therefore, while multifocal IOLs can improve vision for some patients, those with advanced macular degeneration may not experience the same level of benefit.

2. Assessment of Visual Potential: Before proceeding with surgery, it is crucial for the ophthalmologist to assess the extent of macular degeneration. This can be done through various imaging techniques, such as optical coherence tomography (OCT) or fundus photography, which can help determine the condition of the macula and the potential for visual improvement post-surgery. If the macular degeneration is mild and the patient has good visual potential, multifocal IOLs may still be a viable option. However, if the degeneration is advanced, the surgeon may recommend a different type of lens, such as a monofocal IOL, which focuses on a single distance and may provide clearer vision overall.

3. Surgical Considerations: In your case, since your mother has already undergone cataract surgery in one eye with multifocal IOLs and has not seen significant improvement, it is essential to discuss the outcomes and expectations with her ophthalmologist. If the right eye has not progressed well, it may be prudent to delay surgery on the left eye until a thorough evaluation is completed. The surgeon may suggest using a monofocal lens for the left eye, especially if the right eye's performance with multifocal IOLs has not met expectations.

4. Patient Expectations and Quality of Life: It's also important to manage patient expectations. While multifocal IOLs can provide a degree of independence from glasses, they may not restore vision to the level experienced prior to the onset of cataracts or macular degeneration. Ensuring that your mother understands the potential outcomes and limitations of the surgery is vital for her satisfaction and mental well-being.

5. Postoperative Care and Monitoring: After any eye surgery, including cataract surgery with multifocal IOLs, regular follow-up appointments are crucial. These visits allow the ophthalmologist to monitor the healing process and the effectiveness of the lenses. If there are concerns about the progression of macular degeneration or the performance of the IOLs, adjustments can be made, and additional treatments may be considered.

In conclusion, while multifocal IOLs can improve vision for many patients, those with macular degeneration may face challenges. A thorough evaluation by an experienced ophthalmologist is essential to determine the best course of action, taking into account the specific condition of the macula and the patient's overall visual needs.

Similar Q&A

Is a Multifocal Intraocular Lens Right for My High Myopia?

Hello Dr. Chang, I am 31 years old and have high myopia. I recently underwent an evaluation for myopia surgery at the hospital. Here are the examination details I remember: my myopia is approximately 1100-1200 degrees in both eyes, with astigmatism around 125-200 degrees. My cor...

Dr. Zhang Yanrui reply Ophthalmology
Given your condition, with a visual acuity of 1.0, it is unlikely that any physician would strongly recommend cataract surgery; especially since you are only in your thirties and have good accommodation ability of your natural lens. Artificial lenses do not have the ability to ac...

Can You Use Different Intraocular Lenses for Each Eye?

Hello, I usually spend a lot of time on the computer, read newspapers, and use my phone less frequently, with less emphasis on long-distance vision. However, I have high myopia and over 100 degrees of astigmatism. If I wish to reduce my dependence on glasses after surgery, can I ...

Dr. He Jianxian reply Ophthalmology
Using different artificial lenses for each eye primarily depends on the individual’s specific condition, which can vary. As long as the patient can adapt, it is not an issue; however, if adaptation is not possible, it can become problematic. This cannot be assessed in advance. Dr...

Understanding Intraocular Lenses: Cataracts, Glaucoma, and Vision Clarity

1. Why are multifocal intraocular lenses not suitable for patients with glaucoma? 2. Are aspheric intraocular lenses suitable for glaucoma patients? Do they have side effects? After surgery with aspheric intraocular lenses, will patients still experience blurriness when looking...

Dr. Ke Meilan reply Ophthalmology
Hello: 1. If the pupil is too small, it may not be suitable; if the vision is too poor, then the multifocal lens may not provide adequate results. 2. Generally, it can be used without side effects. Yes, because it is aspheric, it does not have multifocal capabilities. 3. National...

Understanding Multifocal Toric IOLs: Correction Limits and Insurance Queries

Recently, I developed cataracts in my eyes. I originally wanted to replace them with multifocal toric intraocular lenses, but my doctor told me that this type only corrects up to -8.00 diopters. However, I saw a video on YouTube that mentioned lenses correcting up to -9.00 diopte...

Dr. Cai Wenyuan reply Ophthalmology
Hello: You may inquire with the National Health Insurance Administration. Wishing you peace and good health. Sincerely, Dr. Tsai Wen-Yuan, Director of the Ophthalmology Department, Taoyuan Hospital, Ministry of Health and Welfare.