Clear-Lens Extraction with Multifocal Lens Implantation

The options for treating the refractive surgery patient are greater now than at any time in ophthalmic history. Although excimer laser refractive surgery is growing in popularity, it has limitations in treating extreme degrees of myopia and hyperopia. In addition, presbyopic patients undergoing corneal refractive surgery must rely on reading glasses or monovision to obtain the full range of visual function. We have found an increased use and success for clear-lens replacement and multifocal intraocular lens (IOL) implantation in our practice. High hyperopes, presbyopes, and patients who have borderline cataracts and have presented for refractive surgery have been ideal candidates for this new technology. Multifocal IOL technology offers patients substantial benefits. The elimination of a presbyopic condition and restoration of normal vision by simulating accommodation greatly enhances the quality of life for most patients. The only multifocal IOL available for general use in the United States is the AMO Array (Allergan Surgical Products, Irvine, CA). The advantages of astigmatically neutral clear corneal cataract surgery have allowed for increased use of multifocal technology in both cataract and clear-lens replacement surgery. Careful attention to patient selection, preoperative biometry and lens power calculations, and meticulous surgical technique will allow surgeons to offer multifocal technology to their patients with great success.