Figure 5-13 A, The AcrySof ReSTOR lens. B, The ReZoom lens. (Part A courtesy of Alcon Lab oratories; part B courtesy of Ab b ott Medical Optics.)

Clinical Results of Multifocal Intraocular Lenses

Some multifocal IOLs perform better for near vision; others, for intermediate. Studies have shown a benefit to using a combination of these lenses in the same patient.

The best-corrected visual acuity may be less with a multifocal IOL than with a monofocal IOL; this difference increases in low-light situations. However, the need for additional spectacle correction for near vision is greatly reduced in patients with multifocal IOLs. Some patients are quite pleased with multifocal IOLs; others request their removal and replacement with monofocal IOLs. Interestingly, patients with a multifocal IOL in one eye and a monofocal IOL in the other often seem to be less tolerant of the multifocal IOLs than are patients with bilateral multifocal IOLs.

Patient selection is crucial for successful adaptation to multifocal IOLs. Selected patients must be willing to accept the trade-off—particularly in low-light situations—between decreased performance at distance vision (and at near vision, compared with that of a monofocal IOL and reading glasses) and the possibility of seeing well enough at all distances to be able to dispense with spectacles altogether. This technology will continue to evolve.