For now, among the more reliable ways to address presbyopia is implanting a multi-focal IOL. These are typically diffractive in nature and the incoming light is split into either two (bifocal) or three (trifocal) focal points to give patients a wider range of vision. The downside is that splitting the light comes with compromises in contrast, visual quality, and particularly night vision.
In the future, there is no doubt that we will instead rely on different IOL designs such as the LensGen Juvene which is a dual optic, curvature changing, modular design which can give three (or more) diopters of focal range without the limitations of a multifocal IOL. We will feature a full video of the LensGen Juvene here on CataractCoach on Thursday, March 14, 2019.
For multifocal lenses, the three primary pearls are:
- Pearl 1: make a consistent, well-centered, appropriately sized capsulorhexis to securely hold the IOL
- Pearl 2: you really must be very accurate with the IOL calculations and in this regard, I recommend that you use the Ladas Super Formula with Artificial Intelligence (available for free at www.IOLcalc.com)
- Pearl 3: make sure that the concentric rings are centered in the visual axis and pupil by using the Purkinje images.
Click below to learn the pearls for using multi-focal IOLs: