Clinician: Monofocal lenses offer best refractive results for glaucoma patients

ATLANTA — Glaucoma patients undergoing IOL implantation have special concerns related to the disease, such as contrast sensitivity issues, anatomic changes and the progressive nature of the disease, rendering monofocal lenses the best lens option for those patients, a physician said here.

"I think monofocal lenses are an excellent way to deal with spectacle independence," Bradford J. Shingleton, MD, said at the Glaucoma Subspecialty Day at the American Academy of Ophthalmology meeting.

He said multifocal lenses do not address the specific problems presented by glaucomatous progression in primary open-angle glaucoma patients undergoing cataract surgery or refractive lens exchange.

Loss of contrast sensitivity from glaucomatous damage is a major issue for glaucoma patients, he said. Multifocal lens technology reduces contrast sensitivity, which could impair patients' night and driving vision, he said.

Anatomic issues are also of great importance, Dr. Shingleton said. Multifocal lenses are pupil dependent, requiring a normal pupil shape and size, which might not be possible in some medically treated glaucomatous eyes, he said.