Multifocal Intraocular Lens Improves Quality of Life

The innovation of the multifocal intraocular lens (IOL) heralds a new era with another option for cataract surgery. The conventional monofocal IOL has become the standard visual rehabilitation during the past decades. Patients have had to depend on near-vision spectacles due to lack of accommodation, or they have to choose monovision from a disparity in both eyes for their daily lives. The multifocal IOL differs from the monofocal IOL in that it has forfeited the loss of contrast sensitivity, which is significant only below 11%. Patients with cataracts who have to spend their lives in a twilight environment and night-time work conditions may be disturbed by glare and ghostly images.

In Thailand, since June 1998, the multifocal IOL has become another choice for patients with cataracts who would like to maximise their quality of life with less dependency on glasses. However, patient selection is a crucial step. Suitable candidates are those whose myopic astigmatism does not exceed 1.0 diopter, spend their lives mostly in a normally lit environment and have no other ocular diseases. Patients with cataracts from all walks of life, ranging from homeworkers, architects, students, businessmen, and medical and paramedical personnel, have had multifocal IOLs successfully implanted with satisfying results.

Bilateral implants in patients with underlying hyperopia result in the most satisfying outcomes. Target emmetropia or a slight hyperopic shift minimises glare and visual disturbance. The multifocal IOL improves the quality of life in the new millennium.

Ataya Euswas
Ramathibodi Hospital, Mahidol University
Bangkok, Thailand