Two to five times a week, a patient sits across from me and asks some version of the same question:
“Should I get the multifocal lens so I do not need glasses, or should I just go with the standard lens?”
It is one of the most important decisions in cataract surgery. And it deserves an honest answer, not a sales pitch.
Both lenses are excellent. Both restore clear vision. But they work differently, and they involve different tradeoffs. Understanding those tradeoffs before surgery is the difference between being happy with your result and wondering if you made the wrong choice.
A monofocal lens has one focal point. It is typically set for distance vision, meaning everything far away, driving, watching television, seeing faces across a room, is sharp and clear.
What you gain:
What you give up:
For many patients, this is the right choice. The vision is clean, predictable, and free of optical side effects. If you do not mind reaching for readers, a monofocal lens delivers excellent results with the fewest surprises.
A multifocal lens uses concentric rings built into the optic to split incoming light into multiple focal points, typically for distance, intermediate (computer), and near vision.
What you gain:
What you give up:
Most patients who choose a multifocal lens are happy with the result. The halos improve over the first three to six months as the brain adapts. But they do not disappear entirely. If you drive a lot at night or are sensitive to visual disturbances, this is important to understand before surgery.
These simulations illustrate the general visual experience. Individual results vary based on eye health, lens model, and neural adaptation.
Monofocal: Sharp distance, readers needed for near
Multifocal: Distance and near, slight contrast reduction
In bright daylight, both lenses provide good functional vision. The monofocal is slightly crisper at distance. The multifocal adds near capability at the cost of a subtle reduction in overall sharpness.
This is where the difference matters most. The halos from a multifocal lens are most noticeable when driving at night.
Monofocal: Clean headlights, minimal glare
Multifocal: Halos and starbursts around lights
The halos are a direct result of how multifocal lenses work. Light is split into rings for different focal points, and those rings become visible around bright light sources. Most patients adapt. Some never stop noticing them.
There is a third option that many patients find appealing. Extended Depth of Focus (EDOF) lenses, like the Vivity, stretch the focal range rather than splitting light into distinct points.
The result is good distance and intermediate vision (computer, dashboard, cooking) with significantly fewer halos than a multifocal. The tradeoff is that fine near vision, small print and phone text, may still require reading glasses.
For patients who want some glasses independence without the full halo profile of a multifocal, an EDOF lens is often the sweet spot.
Patients often ask me which lens I would choose for myself. The honest answer is that it depends on which version of me is answering.
The version that reads for hours every night might choose a multifocal. The version that drives dark desert highways after late surgeries might choose a monofocal. The version that spends most of his day at a computer might choose an EDOF.
That is the point.
There is no universally best lens. There is only the best lens for your eyes, your measurements, your corneal surface, your tear film, your daily routine, and your tolerance for tradeoffs. That is why the consultation matters more than the brochure.
When I recommend a monofocal lens, it is not because I am being conservative. It is because I looked at your eyes and determined that a monofocal will give you the cleanest, most reliable outcome.
When I recommend a multifocal, it is because your measurements, your surface health, and your lifestyle all point toward it being a good fit.
Either way, you deserve to understand what you are choosing and what you are giving up. That is what this page is for.
The answer starts with a conversation, not a brochure. Dr. Tokuhara takes the time to understand your eyes and your daily life before making a recommendation.