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Cataract Surgery: The Innovations Continue


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.

Whatever its final role, the multifocal implant is in keeping with other innovations in cataract surgery. Fifty years ago, the researchers who developed lens implants were considered renegades and shunned by their colleagues. Implants are now considered a standard of care for the treatment of cataracts. Future treatment may involve an implant with the elasticity of a youthful lens, so that, as in a young eye, the lens itself can be reshaped by the eye's focusing muscles for near and distance vision, Trattler tells WebMD.

As with any other surgical procedure, cataract patients can help themselves by being informed consumers, Steinert tells WebMD. The type of vision correction that is most appropriate, and therefore the most suitable lens implant, varies among patients, he says.

The study was funded by Allergan Inc., the makers of the ARRAY lens. Study authors Javitt and Steinert have been consultants to Allergan but have no other financial interests in the company or in this product.



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