Refractive Lens Surgery

Monofocal Lens Implants

These lenses have a single focal point and have minimal side effects. However, if distance vision is targeted, then near vision glasses are required for all near vision tasks. These are the lenses provided within the NHS. Most UK private health insurers cover the cost of these lenses. These lenses do not correct astigmatism; therefore, you will still need glasses for all of your activities if you have significant astigmatism and also for near vision and reading unless monovision is performed. There are advanced monofocal lenses with high asphericity built-in.

Advanced Premium Lens Implants

These lenses have the advantage of providing you with a wider range of focus with clear vision without glasses than monofocal lenses. They will significantly reduce your dependency on glasses for most daily activities, including computer work, watching TV and driving. These 11 lenses are much more expensive than basic monofocal lenses and therefore are not normally available within the NHS.

Enhanced Depth of Focus (EDOF) Lens

The extended depth of focus lenses provides crisp distance vision with excellent intermediate vision with minimal optical side effects. The aim is to provide clear distance vision with the ability to work on a computer and read larger print at arm’s length without glasses. Low power glasses are expected to be needed for reading closely, or in dim light. It is the go-to lens of choice for many surgeons and patients providing the best compromise of minimal optical side effects with extended range of focus. Increasing focus range beyond the EDOF lens range is then associated with increasing optical side effects. It has been called a zero sum gain.

Premium Full Multifocal Lens

Full multifocal lenses enhance the range of clear vision (focus) of the eye, compared to single focus and EDOF lenses. They are not the same as bifocal, trifocal or varifocal glasses, where looking through differing parts of the lens delivers a range of focus.

Most people with multifocal lenses either do not use glasses or have minimal need for glasses but optical side effects are expected. Any change in vision causes the retina and brain to adapt neural connections over a number of months, so side effects improve over time, but are expected to remain to a greater or lesser extent.

Side effects of full multifocal lenses include reduced contrast of vision and halos around bright lights, which are generally not bothersome for most people but can be for some. This includes lights in a supermarket as well as night driving. If there is a need for extended night driving or best vision in low light, then single focus or EDOF lenses are generally recommended.

For those with large astigmatism, then full multifocal lenses provide too many side effects. A single focus or EDOF lens is commonly more suitable. As a generalisation, the greater the range of focus, the more optical side effects, which is why many ophthalmologists prefer lenses which deliver the maximum range of focus with minimal side-effects.

Toric Lens

These lenses correct astigmatism. The alternative is to have this done by using a femtosecond laser for laser cataract surgery.

Refractive lens surgery

Some people choose to have lens surgery before cataracts fully develop, often in their 50s, to eliminate, or reduce, the need for glasses, or regain near vision. By combining astigmatism correction with a multifocal lens implant, up to 92% see well at distance, intermediate and near, they may occasionally use glasses or never use glasses. The remaining 8% also see well but they use their glasses more than just occasionally.

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