Presbyopia, or simpler, near vision disturbance, is a common problem for patients after the age
of 45, and sometimes even earlier. This issue can be solved today with the implantation of
multifocal intraocular lenses, or even with the extended depth of focus (EDOF).
Types of intraocular lenses
When it comes to presbyopia, there are two types of intraocular lenses that can solve this
refractive error. The first ones are diffractive trifocal intraocular lenses. The optic of these lenses
is designed with more than one focal zone, which means that depending on the pupil size the
person can see far, intermediate, and near without glasses, and all depending on the focal zone
they are looking through. On the other hand, the EDOF lenses are the latest technological
achievement when it comes to correcting vision over all distances. This technology is more
reliant on the natural pupil size and has only two indistinct focal zones. With these lenses,
patients can have excellent far and intermediate vision, and very good near vision. Some patients
must wear reading glasses even after the implantation of these lenses, but usually only for the
smallest print. However, their advantage is lack of photic phenomena, also known as halos and
glare. This phenomenon is seen in all diffractive trifocal intraocular lenses and consists of
starbursts that patients see during the night and slight decrease in contrast sensitivity.
Who are the best candidates for this procedure?
Almost all patients older than 45 years who want to get rid of their reading glasses are good
candidates for this surgery. There is no upper age limit, but it is important that the macula (back
of the eye) is healthy and preserved to get full effect of these lenses.
Preoperative examination
Before the surgery, a detailed examination of the anterior and posterior segments of the eye is
performed, and a calculation of the intraocular lens power is made. The patient is presented with
the results and based on a detailed conversation with the surgeon, the best option is chosen. We
emphasize that preoperative patient/surgeon consultation is of the utmost importance. A patient’s
everyday activities, habits and expectations are thoroughly discussed, so there is no
missunderstanding about potential postoperative limitations.
What does the surgical procedure look like?
The surgical procedure lasts only 10 minutes per eye. Sometimes we do one eye first and the
other one in the next few days, but oftentimes both eyes are operated on the same day. In almost
all patients the topical anesthesia (anesthesia with the eyedrops) is sufficient. During the
procedure, the natural eye lens is removed, and an EDOF/trifocal lens is implanted in its place.
The incisions heal by themselves, so there is no need to suture the wound.
What does the postoperative period look like?
The recovery lasts several days, usually five to six. During this time, the patient is advised to
avoid smoke, wind, and dust, as well as lifting heavy weights. Antibiotic/corticosteroid eyedrops
are also used during this time.
These lenses are permanent, they do not need to be exchanged, nor can they become cloudy like
our natural eye lenses, which means that cataract cannot develop on them.
