Best monofocal IOL on the market

[Adammo]

Hi guys,

I'm a young man (25) facing unilateral cataract surgery (in Europe).

I need the best possible outcome in terms of acuity, absence of glare / halo, side effects.

What is the best IOL on the market in your opinion? I need a monofocal one without blue blocker.

1. Alcon Aspheric (SA60WF) - lots of warinings about glistening in terms of Acrysof material.
2. Tecnis 1-piece ZCB00 - smaller effective optic diameter (+/- 5 mm) due to peripherial ring design.
3. B+L enVista MX60E - not much data and relatively new.

I'll appreciate your help,

Adam

[Root710]

If you are in Europe you should give the Alcon Clareon lens serious consideration.  Seems to fit all of your criteria and more without glistening.  It’s what I was interested in but not available hear in the United States yet.  Received it’s CE Mark in Europe approx. 9/17.

[JohnHaganMD]

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[John C Hagan III, MD, FACS, FAAO]

I'm certainly not going to try to talk you into an acrylic IOL.  My wife had two Technis acrylic 3 piece ZA9003 put in this past year with spectacular results. I certainly would not have allowed that if I though it a problem nor would we use them in our practice.  I have easily managed over 15,000 acryilic IOL patients without any complaints due to glistenings. But you can go with a silicon IOL.    THIS IS FROM THE TECNIS WEBSITE so take it like all advertising with a critical eye  "LONG-TERM SUSTAINABILITY
Unlike another leading IOL, TECNIS® IOL material is not associated with glistenings,5-9which can inhibit your patients’ vision. Glistenings cause light scatter, which can result in a reduction in image contrast.5-10"

[John C Hagan III, MD, FACS, FAAO]

Adam. Supposed you asked "what is the best car made. I want the absolute best."  You would get a lot of different answers because there is no best automobile. Lots of excellent automobiles. Same with IOLs. I have no experience with the last one you list but the other two are quality IOLs and the acrylic 'glistenings' while common are something 99.99% of people are unaware of.   Read this:  https://www.medhelp.org/user_journals/show/1648102/Consider-ALL-the-Options-Before-Your-Cataract-Surgery-Working-Through-Whats-Best-For-You    ; Your biggest choices are:  surgeon, type of anesthesia, post operative uncorrected refractive error

[Adammo]

Dear Dr. Hagan,
thank you for your reply. I do agree that that there's no simple anwser. However, I think that IOL choice does matter.
I was adviced by some opthamologists to aviod Acrysof by all means as its material is much more likely to develop glistening. It is also supported by studies I believe.
On the other hand, I am worried that reduced effective optical area to 5 mm in case of Tecnis ZCB00 may not be enough for my young pupil.

This choice is crucial to my career as I am a commercial pilot.
I'd appreciate your opinion.

[MrPresley]

Acrysof monofocal here with no glistening after 14 months and 20/15 corrected vision.