He is an acquaintance of a patient who had cataract surgery with multifocal lenses at our clinic (Cataract Surgery Case #21), and was referred to us by another eye clinic wishing for surgery. He had an advanced cataract in one eye and had felt it was affecting his driving for about five years. In the preoperative interview he wished to use advanced medical care insurance, and said he did not mind using reading glasses when needed but wanted to see clearly at distance, including when driving, without glasses, so we recommended ActiveFocus, which has few halos and glare.
Both eyes had mild corneal astigmatism, borderline for using toric lenses, so we explained that we would first operate on the non-dominant left eye with a non-toric lens and, if the postoperative astigmatism bothered him, use a toric lens in the dominant right eye; he agreed.
The surgery was completed without problems, and postoperative uncorrected vision in the left eye was good at 1.2 distance / 0.7 near; for the right eye, at his own wish to have the best lens since he was having surgery anyway, we used a toric lens. As a result, right eye uncorrected vision after surgery was 1.5 distance / 0.9 near; although its target refraction was set further toward distance than the left eye's, its near vision was also better than the left eye's, and he was very satisfied. This case confirmed that correcting astigmatism is effective in improving not only distance but also near vision.
Cataract Surgery Cases / Case
Multifocal IOL
Case #28: Man in his 70s from Kokubunji (multifocal lens: toric ActiveFocus)
This is an English translation of the original Japanese case report. If the two differ, the Japanese version takes precedence. Visual acuity is shown in decimal notation (1.0 ≈ 20/20).
Change in visual acuity (decimal; corrected values in parentheses)
Right eye: pre-op → post-op
- Far
- 0.4(1.2)→1.5(n.c.)
- Near
- —→0.9(1.0)
Left eye: pre-op → post-op
- Far
- 0.2p(0.4)→1.2(1.5)
- Near
- —→0.7p(1.0)
2019.06.05
Patient questionnaire
Answers translated from Japanese.
- What was your condition before surgery?
Even with glasses, my left eye in particular was blurry.
- What led you to have surgery?
Because even with glasses, things were blurry when driving, especially at night.
- Which did you choose, a multifocal lens or a monofocal lens?
I chose multifocal lenses because they focus both far and near.