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Multifocal intraocular lenses - a cure for presbyopia?

In the past few years the lens companies have tried to incorporate a substitute for accommodation in their intraocular lens design after lens removal surgery. One lens simulates accommodation with various hinged elements usually between the optic and the haptics (e.g. AT 45 crystal lens ®).The other group incorporates refractive or diffractive principles within the lens to allow a multifocal effect.

I have found the second group to be the most popular although not ideal for every patient. The ReStor ® (Alcon apodized diffractive lens) still gives haloes at night, very good reading but intermediate vision (computer screens) is not as good. The haloing is particularly bad if only one eye has the lens. It is easy to insert but accurate K readings and axial length must be done as the lens size is crucial.

I have also used the ReZoom ® lens (AMO). It too gives haloing and the reading is not as good however it gives better vision for the computer. One of each lens in each eye can give a range of focus that some patients find comfortable. It will be interesting in the future to see the place of multifocal phakic IOLs.

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