Spectacle independence and subjective satisfaction of multifocal intraocular lens after cataract or presbyopia surgery

Abstract

AbstractPurpose Multifocal implantation represents nowadays in the world the first surgical option for presbyopic correction because of their ability to truly provide spectacle independence in more than 80% of cases, despite their goal is to only compensate the loss of accommodation and not to restore it.Methods Actually the success of these lenses and the achieved visual performances have increased with last design refinements that have been brought on diffractive (aspheric, toric, trifocal) or refractive (bifocal aspheric, toric) multifocal IOLs in addition to the adjustment of calculation nomograms, for: better predictability of refractive correction, improved quality of vision with less pupil dependency and custom choice of the IOL model according to each patient needs. Moreover, the use of photoablation or LRI as an enhancement procedure in case of residual refractive error represent a nice option that has allowed to obtain glasses removal in more that 95% of operated patients.Results However selection of patient appears to be the key factor and should be carefully considered in order to guarantee the good surgical outcome: beside anatomical contraindication such macular, retinal problem, severe amblyopia …, preoperative refraction, patient expectations and needs are very important to evaluate. No doubt at that time that hyperopia and age of more than 55 years determine the best candidate. However, indications can be widely enlarged, when informations about limits especially in qualitative vision, postoperative evolutive profile are well explained and accepted before the surgery.Conclusion We will describe the interest of last generations of multifocal IOLs, and report some comparative results between the different concepts.