Surgical treatment of presbyopia II

Article information

J Korean Med Assoc. 2019;62(12):623-628
Publication date (electronic) : 2019 December 12
doi : https://doi.org/10.5124/jkma.2019.62.12.623
Department of Ophthalmology, Bucheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
Corresponding author: Eun Chul Kim. eunchol@hanmail.net
Received 2019 October 30; Accepted 2019 November 16.

Abstract

This review gives an overview of the current multifocal intraocular lenses (IOLs) landscape, in terms of the technology, benefits, and limitations of different premium IOLs, as well as significant clinical outcomes. Cataract is the most common cause of visual impairment in older adults. From 1980, the number of blind and visually impaired people have decreased due to cataract surgery. As the number of surgical procedures increases every year, patient demands have also changed with many patients expecting excellent visual acuity without glasses. Multifocal IOLs can provide spectacle-independence for near, intermediate, and distant vision tasks. Multifocal IOLs can be classified into bifocal, trifocal, and extended depth of focus multifocal IOLs. The ultimate goal of multifocal lenses includes reduced incidence of photic phenomena, and improved uncorrected near, intermediate, and far visual acuities for those working with computers and smartphones, as well as no contrast sensitivity loss. Although some patients have issues with halos and glare, overall patient satisfaction and quality of life are generally high after multifocal IOL implantation. Careful patient selection should be made to satisfy different individual needs.

Acknowledgement

This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) fund-ed by the Ministry of Education (2018R1D1A1A02085334 & 2016R1A6A1A03010528).

Notes

Conflict of Interest

No potential conflict of interest relevant to this article was reported.

References

1. Wang SY, Stem MS, Oren G, Shtein R, Lichter PR. Patient-centered and visual quality outcomes of premium cataract surgery: a systematic review. Eur J Ophthalmol 2017;27:387–401.
2. Sudhir RR, Dey A, Bhattacharrya S, Bahulayan A. AcrySof IQ PanOptix intraocular lens versus extended depth of focus intra-ocular lens and trifocal intraocular lens: a clinical overview. Asia Pac J Ophthalmol (Phila) 2019;8:335–349.
3. Charman WN. Wavefront aberration of the eye: a review. Optom Vis Sci 1991;68:574–583.
4. Ye M, Bradley A, Thibos LN, Zhang X. The effect of pupil size on chromostereopsis and chromatic diplopia: interaction between the Stiles-Crawford effect and chromatic aberrations. Vision Res 1992;32:2121–2128.
5. Zhao H, Mainster MA. The effect of chromatic dispersion on pseudophakic optical performance. Br J Ophthalmol 2007;91:1225–1229.
6. Gallego AA, Bara S, Jaroszewicz Z, Kolodziejczyk A. Visual Strehl performance of IOL designs with extended depth of focus. Optom Vis Sci 2012;89:1702–1707.
7. Lane SS, Morris M, Nordan L, Packer M, Tarantino N, Wallace RB 3rd. Multifocal intraocular lenses. Ophthalmol Clin North Am 2006;19:89–105.
8. Lawless M, Hodge C, Reich J, Levitz L, Bhatt UK, McAlinden C, Roberts K, Roberts TV. Visual and refractive outcomes following implantation of a new trifocal intraocular lens. Eye Vis (Lond) 2017;4:10.
9. Xu X, Zhu MM, Zou HD. Refractive versus diffractive multifocal intraocular lenses in cataract surgery: a meta-analysis of randomized controlled trials. J Refract Surg 2014;30:634–644.
10. Kohnen T, Böhm M, Hemkeppler E, Schönbrunn S, DeLo-renzo N, Petermann K, Herzog M. Visual performance of an extended depth of focus intraocular lens for treatment selection. Eye (Lond) 2019;33:1556–1563.
11. Mesci C, Erbil HH, Olgun A, Aydin N, Candemir B, Akcakaya AA. Differences in contrast sensitivity between monofocal, multifocal and accommodating intraocular lenses: long-term results. Clin Exp Ophthalmol 2010;38:768–777.
12. Alio JL, Plaza-Puche AB, Fernandez-Buenaga R, Pikkel J, Maldonado M. Multifocal intraocular lenses: an overview. Surv Ophthalmol 2017;62:611–634.
13. Braga-Mele R, Chang D, Dewey S, Foster G, Henderson BA, Hill W, Hoffman R, Little B, Mamalis N, Oetting T, Serafano D, Talley-Rostov A, Vasavada A, Yoo S. ASCRS Cataract Clinical Committee. Multifocal intraocular lenses: relative indications and contraindications for implantation. J Cataract Refract Surg 2014;40:313–322.
14. Chung TY. Clinical outcomes of currently available multifocal intraocular lenses. J Korean Med Assoc 2019;62:533–539.

Article information Continued

Funded by : National Research Foundation of Koreahttps://doi.org/10.13039/501100003725
Award ID : 2018R1D1A1A02085334
Award ID : 2016R1A6A1A03010528

Figure 1

Refraction. The change in direction of a light passing from one medium to another.

Figure 2

Diffraction. The waves of light can be generated through small aperture.

Figure 3

Refractive multifocal intraocular lens: ReZoom (courtesy of AMO).

Figure 4

Refractive multifocal Intraocular lens: Precizon (courtesy of Ophtech).

Figure 5

The surface of diffractive multifocal intraocular lens.

Figure 6

Apodization of diffractive multifocal intraocular lens (courtesy of Alcon).

Figure 7

Small aperture enhanced depth of field intraocular lens (courtesy of AcuFocus).