Intra ocular lens - what do I choose ! ?

Which lens are good for cataract surgery? Monofocal phaco with generic hydrophobic foldable IOL or phaco spherical monofocal IOL three piece?

Cataract surgery though looks as simple but it's a most complicated procedure .Cataract may occur in different age groups from age 0 months to 100 yr. The nature of cause varies .

People of age 60yrs , generally hydrophobic acrylic aspheric single piece intraocular lens(SUPRAPHOB) is most preferred .

If u want spects free for both distant and near vision after surgery you should go SUPRAPHOB TORIC lens.

Why hydrophobic(costly)advised over hydrophilic (cheaper) because it has less chance of "after cataract" (ie.a thin layer may form after removing of cataract )which causes blurring if vision for that laser is required to remove.

Three piece IOL is used mainly if any complication occurs during surgery .No need for routine cases.

Aspheric intraocular lens is better than spheric intraocular lens because of less aberration i.e., more clarity of vision .

2. Are toric multifocal lenses the best for cataract surgery?

Generally we implant intraocular lens (IOL) which is tailored fit to individual patient. All patients don't fit in a single basket . The IOL selection mainly depends upon the patients education level and perception about the treatment given . In medical care the ultimate goal is patient satisfaction .For eg

The above pic is multifocal IOL which has different zones/rings for distant, intermediate and near vision. It's advantage is that patient don't need near vision glasses after cataract surgery. But it's main implication is it produces rings/halos while driving in night and reading book in relatively dim light . An educated young patient easily adapt and ignore them where as for an uneducated and old patient who can't ignore or adapt ,it is difficult for them .Even after getting 6/6 or 20/20 vision after surgery patient may not be satisfied if he can't adapt to the type of lens implanted .so ultimately the patient blames doctor if he has not informed well about these implications.

The above pic is monofocal IOL without any rings which we usually implant in old patient which corrects spherical number only. They are fully satisfied even though they need near vision glasses after cataract surgery because they are habituated to near vision glasses but not habituated to the rings/halos.

The above pic is toric IOL where u can see 2 marks indicating cylinder (layman term) used for both spherical and cylinder number correction

The above pic has both rings and marks .It is toric multifocal IOL which corrects cylinder number also(if patient has) .

There are many other types of IOL .The above one is just a pint about multi focal IOL.