Cataract surgery: is a multifocal lens worth choosing?

Fewer glasses can involve trade-offs

The main reason for choosing a multifocal intraocular lens during cataract surgery is to increase the chance of seeing at different distances without glasses. It does not mean everyone will be completely free of glasses, and a higher price does not necessarily mean a better fit.

A monofocal lens mainly focuses at one distance. If it is targeted for distance vision, reading books or using a phone often still requires glasses. Multifocal lenses can improve unaided near and intermediate vision, but halos, glare and reduced contrast sensitivity are more common.[1,2] Reduced contrast sensitivity means that objects with similar shades are harder to distinguish; vision is about more than the line you can read on an eye chart.

If you often drive at night, rings around lights and glare deserve particular discussion. If reading without glasses matters most, that benefit may come with visual disturbances. The comparison is about which visual experiences matter to you, rather than ranking lenses as premium or ordinary.

The retina and cornea affect the choice

Patient information from the Eye Hospital of China Academy of Chinese Medical Sciences, published by the Beijing Municipal Health Commission in 2024, emphasizes that an ophthalmologist should first perform preoperative examinations, measurements and assessment, then consider lifestyle and visual needs. Lens selection requires greater care when conditions affecting the macula, retina or optic nerve impair vision.[1]

Cataract may account for only part of the visual impairment. Replacing a cloudy natural lens cannot also remove existing retinal or optic nerve damage. The European Society of Cataract and Refractive Surgeons includes other eye conditions, the wish to reduce dependence on glasses and realistic expectations among selection factors. Additional corneal examinations, retinal optical coherence tomography (OCT) and dry-eye assessment may be considered as needed.[2]

“I want to avoid glasses” is a goal to explain, not a substitute for suitability assessment. Having another eye condition does not automatically rule out cataract surgery. The doctor needs to explain what the operation can improve and which lens benefits may be limited.

Astigmatism correction is not the same as multifocality

“Toric” and “multifocal” describe different functions. Toric lenses address corneal astigmatism; multifocality concerns focusing at far, intermediate or near distances. The Chinese eye hospital’s public information describes both monofocal toric and multifocal toric lenses.[1] Having astigmatism therefore does not automatically mean needing a multifocal lens.

Another common term is extended depth of focus (EDOF). It should not simply be equated with multifocality. The European society’s comparison describes good intermediate and distance vision with EDOF lenses and generally fewer visual disturbances, while glasses may still be needed for close reading.[2] The performance and suitability of a specific model still need individual assessment; a package’s category name is not enough.

Comparing options in the UK and China

Moorfields Eye Hospital in the UK states on its public website that its NHS cataract surgery includes a standard monofocal lens. People wanting a multifocal lens can choose private surgery.[3] This is that hospital’s published service arrangement. It does not mean monofocal treatment is inadequate or that multifocal lenses are unavailable in the UK.

When discussing an option in China, compare the proposed lens type, whether it corrects astigmatism and its main target distance with your UK option. The Chinese hospital’s information supports selection based on examinations and visual needs. It does not mean every Chinese hospital currently stocks the same model or accepts international patients.[1]

If one plan uses a standard monofocal lens and another a multifocal lens, the price difference also reflects different treatment goals. It cannot, by itself, establish which country offers better value. Ask the ophthalmologist what the additional features could offer your eyes and which visual trade-offs they involve. Use the guide to questions before agreeing to treatment to keep a record of the doctor’s reasoning and expected results.