Multifocality comes with compromises
Click Here to Manage Email Alerts
WAIKOLOA, Hawaii — There is “no free lunch” when matching the right patient to the right IOL, Jack T. Holladay, MD, MSEE, FACS, said at Hawaiian Eye 2022.
“Everything we do has a compromise if we produce more multifocality,” Holladay said in a presentation discussing the range of available IOLs, from aspheric monofocal lenses to extended depth of focus, pinhole, bifocal and trifocal lenses.
When considering a monofocal lens, he said physicians should picture 100 rays coming through an aperture to a “perfect point” and then spreading back out.
"What we do with multifocality, whether it is refractive or diffractive, is we take those rays and we move them to a second or third focal point,” Holladay said.
The rays at the far focus have a second image on top of it that creates a halo from the near focus that is out of focus, and there is always a decrease in contrast sensitivity, he said.
“This is the bottom line. When we go from the aspheric monofocal to a trifocal lens, we see an increase of multifocality and we see an increase in depth of field, an increase in spectacle independence and an increase in glare and halo,” Holladay said.
However, when any of these premium lenses are fitted properly to the right patient, the patients are satisfied, he said.
“Realize that for every increase in multifocality there is a tradeoff and a compromise, but if you pick the right patient for their degree, they will end up happy,” Holladay said.
Collapse
Holladay JT. Optics and clinical performance: Mono, EDOF, pinhole, diff/ref, bifocal & trifocal IOLs. Presented at: Hawaiian Eye; Jan. 15-21, 2022; Waikoloa, Hawaii.
Read more about
Click Here to Manage Email Alerts