Extended Depth of Focus (EDOF) and Multifocal Lens Cataract Surgery

What did the Food and Drug Administration’s approval of the first intraocular lens with extended depth of focus mean for cataract patients at Hartford Hospital’s Eye Surgery Center in Newington?

If you have cloudy up-close vision caused by presbyopia, it could mean you won’t need glasses after cataract surgery.

For the first time, with Johnson & Johnson Vision’s Tecnis Symfony intraocular lens implant, patients can expect clear vision at near, immediate and far distances without glasses.

A traditional intraocular lens, or IOL, that replaces a clouded cataract lens corrects either near or distance vision. Most people choose an artificial lens for distance vision and use reading glasses for up-close vision.

The Extended Depth of Focus intraocular lens, or EDOF, gives both you and your cataract surgeon another option when determining the best IOL. 

Ask Your Cataract Surgeon About Presbyopia

Presbyopia is the most common cause of visual impairment.

Symptoms include:

  • Difficulty reading small print.
  • Inability to read without holding the book or magazine more than an arm’s distance away.
  • Difficulty seeing objects close to you.
  • Eyestrain.
  • Headaches.

What Type of IOL Do Cataract Surgeons Use Most Often?

The majority of the 8,500-plus cataract surgeries performed at the Eye Surgery Center in Newington in the past year used a monofocal IOL. This lens has a single focusing distance suitable for up close, medium range or distance vision. Most people choose distance-vision IOLs, so they’ll likely need glasses for reading or close-range work.

What Will My Vison Be Like With an EDOF Lens?

In clinical studies, patients with EDOF lenses could see objects, day or night, clearly and sharply at near, intermediate and long-range distances. Compared to other IOLs, Symfony minimized a phenomenon known as chromatic aberration, which can affect focus when various wavelengths of light reach the lens at different angles. Patients also reported minimal halo and glare, which can affect nighttime driving. (For patients with an astigmatism, when light unevenly focused on your retina creates blurred vision at all distances, the Symfony Toric IOL performs similarly to the Symfony EDOF lens.)

Multifocal Lens: When You're not a Candidate for EDOF

For patients with cataracts and presbyopia, surgeons at the Eye Surgery Center prefer two types of multifocal lens, Alcon’s ReSTOR and Johnson & Johnson Vision’s Tecnis, that allow viewing multiple distances through different parts of the same lens. These lenses act much like bifocal glasses. Multifocal lenses increase your chances of not needing glasses after cataract surgery. 

What’s the Difference Between an EDOF and Multifocal Lens?

To achieve a full range of vision, an EDOF lens creates a single elongated focal point. A multifocal lens has different zones at different powers, requiring your brain to adapt as it determines which visual information to choose when forming an image. Some people will find this sensation uncomfortable.

How Will a Cataract Surgeon Help Me Decide Which Lens Is Best for Me?

Let’s ask Dr. Alan Solinsky, a cataract surgeon who is Director of Development and Innovations at the Eye Surgery Center:

“When a patient is nearsighted,” he says, “I tend to go with the ReSTOR. If a person is farsighted, I think the Symfony works better. If their definition of ‘I want to see well up close’ is reading, you might want the ReSTOR. If you want to see the computer screen, the Symfony is going to be very good.”

Talk to your surgeon about the pros and cons of each lens before deciding which lens is right for you.

What Is Cataract Surgery?

Cataracts are the leading cause of blindness worldwide, according to the World Health Organization. In the United States, more than 24 million people age 40 or older have been affected by cataracts. If you have your cataracts removed, here is what the surgery is like:

How Long Does Cataract Surgery Take?

The surgery takes about 30 minutes, but you’ll be at the Eye Surgery Center in Newington about three hours.

Does the Procedure Hurt?

No. Few people experience serious complications from cataract surgery, the most common procedure in the United States. Choosing a surgeon with considerable experience, like those at the Eye Surgery Center, reduces the likelihood of any complications. 

Will I Feel Anything?

You’ll feel a little bit of pressure. 

Will I Be Put to Sleep?

No. This is an outpatient procedure that uses local anesthesia and topical anesthetic eye drops.

Will You Fix Cataracts in Both My Eyes on the Same Day?

No. Surgery on the second eye is done 2-3 weeks later.

Will Medicare or Insurance Cover an EDOF lens implant?

Medicare covers conventional IOLs, but not EDOF implants that correct presbyopia. They’re not considered medically necessary. Talk to the Eye Surgery Center staff about costs. And if you’re not yet eligible for Medicare, talk to your insurance provider. 

Learn More About Cataract Surgery

Eye Surgery Center