![]() ![]() This extends the range of quality vision with a reduced amount of night vision symptoms. The first extended-depth-of-focus (EDOF) lens, the Tecnis Symfony (Johnson & Johnson Vision) also uses diffractive technology but includes an echelette design to correct the chromatic aberration present in the cornea for improved contrast sensitivity and to produce a pattern of light diffraction that elongates the focus. Subsequent lenses used diffractive IOL technology to improve depth of field while improving visual quality both in the far and near (14” to 20”) ranges. The first multifocal IOLs used zonal refractive technology (more akin to the design of multifocal contact lenses) to split the light to far and near foci. Multifocal intraocular lenses, like multifocal contact lenses, split the focus of incoming light to increase depth of field, resulting in visual quality tradeoffs. Ideally, with contrast and brightness both at 100%, there is no blur, providing a nice, sharp optotype and a high-quality visual experience. Both referring optometrists and surgeons who may have been unhappy with the results of earlier technology should consider newer presbyopia-correcting IOL options, since they offer more advantages and fewer disadvantages compared to older designs.įig. We should at least consider prescribing separate glasses for distance and near, and we should also consider offering surgical options that reduce the need for progressive/multifocal glasses.įortunately, there are many good options to increase the depth of field surgically. ![]() Nevertheless, since falls can be prevented, we should rethink our approach to treating presbyopia. Patients who fall do not typically go to their eye doctors therefore, the eye care community has not appreciated the impact of these incidents on our patients. 2 Falls also threaten the independence and quality of life of seniors. In fact, an older adult falls every second of every day, leading to seven million injuries, and over 27,000 elderly deaths (more than from breast cancer or prostate cancer) annually. 1 The Centers for Disease Control (CDC) reports that falls are a leading cause of injury and death in older Americans. ![]() One study found that multifocal spectacle wearers were more than twice as likely to fall and that multifocal glasses accounted for nearly 41% of the attributable risk for falls outside the home. Multifocal (bifocal, trifocal and progressive) spectacles contribute significantly to the risk of trips and falls in the elderly. While some doctors avoid recommending presbyopia-correcting lenses altogether because of concerns related to possible dysphotopsias, it is important to consider that not correcting presbyopia surgically and relying on multifocal spectacles can have its own set of risks that are more than just an annoyance. No FDA-approved IOL provides true accommodation akin to that of the human eye, and with all pseudoaccomodating IOLs, increasing depth of field is associated with dysphotopsias in night vision. In spite of these advances, some compromises can still be expected. Modern presbyopia-correcting IOLs offer ranges of options and levels of patient satisfaction not previously possible. The optics of these IOLs have improved in recent years through the correction of optical aberrations and the clever use of diffractive optics to increase depth of field. Presbyopia-correcting IOLs can provide vision without glasses at all distances for patients after cataract surgery, though some compromises are expected. Follow the links below to read other articles from annual update on surgery:Ĭorneal Compromise: How to Assess the Risk of Post-LASIK EctasiaĮxcise and Conquer: Adding Minor Surgical Procedures to the Optometric Office ![]()
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