The wife of a patient who had cataract surgery at our clinic three years earlier came for cataract consultation after a year, because driving at night had recently become difficult and near had become harder to see. Distance vision was still good, but she had age-appropriate cortical cataracts and poor near vision from strong presbyopia, so we told her that surgery was one option.
Night driving would improve even with monofocal lenses, but when we told her she would need reading glasses for near, like her husband, she said she did not want multifocal lenses under the elective treatment system because of the cost, so we proposed LENTIS Comfort, the only insurance-covered multifocal lens.
LENTIS Comfort is a low-add bifocal multifocal lens; its add is 1.5 D, so its near focal distance is about 70 cm. Typical trifocal lenses have a 3.2 D add, with a near focal distance of about 40 cm, so its near vision is inferior. However, LENTIS Comfort is a segmental lens (with the near power in the lower part, like bifocal glasses) without the grooves (diffraction grating) of typical multifocal lenses, so it has far fewer halos and glare and little light energy loss, and its financial burden is low (the same cost as a monofocal); these seem to be points where it is superior.
With this understanding, we set the target refraction to secure at least distance vision and operated with LENTIS Comfort; as a result she was very satisfied that uncorrected vision was 1.5 distance / 1.0 near, near vision better than expected. She reported that she could read without glasses and that night driving in the rain was no problem at all, so almost all her preoperative complaints were resolved.
Since multifocal lens surgery was removed from coverage by advanced medical care insurance in March 2020, cases with LENTIS Comfort have been increasing. Even if you wish for multifocal lenses, test results may show you are not suited to them, so to achieve high postoperative satisfaction, choosing the lens type before surgery and judging candidacy appropriately are important. LENTIS Comfort is a lens that suits some cases more than others, but it seems well suited to people who originally had good distance vision and have developed strong presbyopia, like her. If you are interested, please feel free to consult us.
*Vision is affected by factors such as corneal astigmatism and pupil size, so not everyone will be able to live without glasses as she does.
2020.10.14