Monofocal vs Multifocal IOL

“I tell every cataract patient the same thing: lens choice is a lifestyle decision, not a medical one. A monofocal IOL will give you the crispest, most trouble-free distance vision — but you WILL need reading glasses for everything up close. A multifocal IOL trades a small amount of optical sharpness for the incredible convenience of being glasses-free for 90% of daily tasks. The patients who are happiest with multifocals are those who read a lot, use smartphones frequently, and don't do much night driving. The patients who are happiest with monofocals are those who prioritise crisp, halo-free vision and are perfectly comfortable wearing a pair of stylish reading glasses. There is no wrong answer — only the wrong answer for YOUR lifestyle.”

• I recommend a monofocal IOL for patients who drive frequently at night, work in low-light environments, have early macular changes, or simply want the safest, most predictable outcome with zero visual side effects.
• I recommend a multifocal IOL for patients under 70 with healthy eyes who read extensively, use smartphones/computers daily, and are willing to tolerate 3–6 months of adaptation for the long-term convenience of glasses-free near vision.
• The biggest mistake I see is patients choosing a multifocal purely because it sounds 'premium' without understanding the night-vision trade-offs. A well-informed monofocal patient is happier than a poorly-informed multifocal patient.