The multifocal cornea: offering better vision to patients with monofocal IOLs


The author proposes a new method for the correction of refractive residual defects for eye with monofocal pseudophakia in order to achieve spectacle independence.

Key Points

Multifocal IOLs represent an enormous advance in cataract surgery; they can offer patients independence from glasses and/or contact lenses. But what about those patients who have already received monofocal IOLs following cataract surgery? These patients often require glasses for near vision and, when combined with residual astigmatism or a refractive defect, they may also be dependent on glasses for distance vision.

We propose a new method for the correction of refractive residual defects for eyes with monofocal pseudophakia, with the creation of a multifocal cornea and correction of the refractive residual defect, in order to achieve spectacle independence for this group of patients.

Procedure & technique

The mean age of patients was 66 years (range: 59 to 74 years). Cataract surgery was performed, on average, 9.2 months preoperatively (range: 3.2 months and three years). Mean follow up was 7.8 months (range: 4.5 months to 15.5 months).

In 13 eyes the surgical technique was LASEK, while LASIK was performed in the remaining two eyes. The mean preoperative refractive defect measured as spherical equivalent was +1.64 (-0.94 to +2.77). All eyes underwent a complete ophthalmological evaluation preoperatively, including a wavescan examination and the same postoperative evaluation at one, three and six months and every three months thereafter.

It's all in the results

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