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Cataract Surgery: The Innovations Continue

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The goal with multifocal implants has been to enable patients to be less dependent on spectacles after surgery. In this study, the investigators followed almost 250 patients, divided almost equally between patients receiving multifocal lenses and conventional lenses. All patients had cataract surgery on both eyes, and they had similar lenses in both eyes. Three months after surgery, patients with multifocals had better average near vision than the group with conventional lenses. The patients' average corrected distance vision was better for the multifocal lenses as well.

Among the patients overall, 32% patients with multifocals and 8% of those with conventional lenses reported that they never wore glasses. On a scale of 0 to 10, with a best possible score of 10, patients with multifocal implants gave their uncorrected vision a score of 8.4, compared to 7.9 for patients with conventional lenses. However, patients with multifocals were more likely to report annoying visual disturbances that can interfere with night driving, such as haloes and glare from headlights.

Experts have diverse opinions on how much an advancement the multifocal implant is. "They're not for everybody. The eye in general can only focus in one plane. When we try to have more than one focus ... there is some loss of contrast," Walter Stark, MD, tells WebMD. "Some patients prefer one focal length [to see for distance] and wear glasses to fine-tune visual acuity, rather than a multifocal lens, which can entail a loss in contrast sensitivity and quality of vision." Stark, who was not involved in the current research, is a professor of ophthalmology and director of cornea and cataract services at the Wilmer Eye Institute of Johns Hopkins University in Baltimore.

"After following patients with multifocals, I have confidence that this is a good lens," William Trattler, MD, tells WebMD. "The one issue is nighttime driving and haloes. Antiglare driving glasses can help minimize this problem." Trattler, who was not involved in the current research, is an instructor in ophthalmology at the University of Miami School of Medicine and an attending surgeon at Miami Baptist Hospital.

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