Presbyopia Correction at the Time of Cataract Surgery
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CATARACT & REFRACTIVE SURGERY (CE STARR AND A BRISSETTE, SECTION EDITORS)
Presbyopia Correction at the Time of Cataract Surgery Brian M. Shafer 1 & Michael Greenwood 2
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review In this article, we review the latest research related to presbyopia management at the time of cataract surgery with attention focused on available options in the USA. Recent Findings With refractive cataract surgery, patient satisfaction is largely dependent on preoperative expectations with regard to spectacle independence and photic phenomena. Monovision with monofocal intraocular lenses have the highest rates of spectacle dependence but the lowest rate of photic phenomena. Extended depth of focus lenses provides excellent distance and intermediate vision, but patients often require glasses for near vision in addition to having mild glare and halos. Refractive multifocal lenses tend to have the highest rates of photic phenomena. Both diffractive and refractive multifocal lenses had excellent near and distance visual acuity but difficulty with intermediate vision. Trifocal lenses provided the most consistent vision at near, intermediate, and distance and only had moderate amounts of glare and halos with excellent patient satisfaction. Summary The current market of intraocular lenses provides patients with the opportunity to experience spectacle independence following refractive cataract surgery. Current options include monovision with monofocal lenses, multifocal intraocular lenses, extended depth of focus intraocular lenses, and pseudo-accomodative intraocular lenses. Future technology is focusing on accommodation, pinhole apertures, and improved multifocality. Keywords Refractive cataract surgery . Presbyopia . Monovision . Multifocal IOL . Trifocal IOL . Extended depth of focus IOL . Accommodative IOL
Introduction Cataract surgery is the most widely performed surgery in the world and has overwhelmingly favorable results. With modern phacoemulsification techniques, visual recovery can occur within days [1]. Typically, the crystalline lens is emulsified and replaced with an intraocular lens (IOL) powered specifically for the patient to correct for positive or negative defocus. Additionally, toric IOL implants are available for management of astigmatism. Standard cataract surgery with a monofocal lens in each eye results in surgically induced presbyopia, which necessitates near-vision correction with bifocals or reading glasses. IOL technology has evolved rapidly This article is part of the Topical Collection on Cataract & Refractive Surgery * Michael Greenwood [email protected] 1
Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA 19104, USA
2
Vance Thompson Vision, West Fargo, ND 58078, USA
in recent years and now provides patients with increasingly broad options for presbyopia correction and reduced dependence on spectacles following cataract surgery. The key to achieving the
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