BCLA CLEAR presbyopia: Management with intraocular lenses

Abstract

Cataract surgery including intraocular lens (IOL) insertion, has been refined extensively since the first such procedure by Sir Harold Ridley in 1949. The intentional creation of monovision with IOLs using monofocal IOL designs has been reported since 1984. The first reported implantation of multifocal IOLs was published in 1987. Since then, various refractive and or diffractive multifocal IOLs have been commercialised. Most are concentric, but segmented IOLs are also available. The most popular are trifocal designs (overlaying two diffractive patterns to achieve additional focal planes at intermediate and near distances) and extended depth of focus designs which leave the patient largely spectacle independent with the reduced risk of bothersome contrast reduction and glare. As well as mini-monovision, surgical strategies to minimise the impact of presbyopia with IOLs includes mixing and matching lenses between the eyes and using IOLs whose power can be adjusted post-implantation. Various IOL designs to mimic the accommodative process have been tried including hinge optics, dual optics, lateral shifts lenses with cubic-type surfaces, lens refilling and curvature changing approaches, but issues in maintaining the active mechanism with post-surgical fibrosis, without causing ocular inflammation, remain a challenge. With careful patient selection, satisfaction rates with IOLs to manage presbyopia are high and anatomical or physiological complications rates are no higher than with monofocal IOLs.

Publication DOI: https://doi.org/10.1016/j.clae.2024.102253
Divisions: College of Health & Life Sciences > School of Optometry > Optometry
College of Health & Life Sciences > School of Optometry > Optometry & Vision Science Research Group (OVSRG)
College of Health & Life Sciences
Aston University (General)
Funding Information: BCLA CLEAR™ Presbyopia was facilitated by the BCLA, with financial support by way of educational grants for collaboration, publication and dissemination provided by Alcon, Bausch + Lomb, CooperVision, EssilorLuxottica, and Johnson & Johnson Vision.
Additional Information: Copyright © 2024 The Author(s). Published by Elsevier Ltd on behalf of British Contact Lens Association. This is an open access article under the CC BY license (https://creativecommons.org/licenses/by/4.0/).
Uncontrolled Keywords: Diffractive,Extended depth of focus (EDOF),Intraocular lens,Monovision,Multifocal,Refractive,Segmented,Ophthalmology,Optometry
Publication ISSN: 1476-5411
Last Modified: 09 Dec 2024 09:14
Date Deposited: 16 Jul 2024 17:58
Full Text Link:
Related URLs: https://www.sci ... 367048424001450 (Publisher URL)
http://www.scop ... tnerID=8YFLogxK (Scopus URL)
PURE Output Type: Article
Published Date: 2024-07-02
Published Online Date: 2024-07-02
Accepted Date: 2024-06-19
Authors: Schnider, Cristina
Yuen, Leonard
Rampat, Radhika
Zhu, Dagny
Dhallu, Sandeep
Trinh, Tanya
Gurnani, Bharat
Abdelmaksoud, Ahmed
Bhogal-Bhamra, Gurpreet (ORCID Profile 0000-0001-8742-6319)
Wolffsohn, James S. (ORCID Profile 0000-0003-4673-8927)
Naroo, Shehzad A. (ORCID Profile 0000-0002-6373-7187)

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