Purpose. To assess the long-term results of presbyopia correction in patients with primary cataract depending on type of implantable IOLs.Material and methods. A profound study of visual functions and assessment of visual quality of 90patients (mean age 63.3±1.2years) with partial cataracts and presbyopia. The studies were conducted before surgery and in late post-operative period after bilateral cataract phacoemulsification with implantation of different models IOLs that provide a high visual acuity in distance and at close range. Results. Bilateral implantation of monofocal IOLs for monovision principle leads to a significant increase in far visual acuity of leading the eye and near visual acuity of slave eye. However, patients need long-term adaptation to artificial anisometropia. As a result of bilateral implantation of accommodating IOLs a significant improvement in visual acuity at distance and near occurs. Surgical treatment provides best visual quality of patients up to 6 months after surgery. In period from 12 to 24months after surgery, there was a decrease of visual functions as a result of fibrosis of capsular bag. The correction of presbyopia by creating a multifocal optical system as a result of bilateral multifocal refractive IOL implantation leads to a stable improvement of visual acuity at far and close distance. But thus the contrast sensitivity deteriorates, especially in low- and high-frequency ranges.Conclusion. Intraocular correction of presbyopia is a highly effective method of treatment, allowing obtaining high visual acuity in distance and at close range. However, the results depend on chosen strategy of intraocular correction.
presbyopia, intraocular correction, multifocal IOLs, accommodating IOLs, monovision, the quality of vision
1. BalashevichLI (2009). Surgical correction of anomalies of refraction and accommodation [Khirurgicheskaya korrektsiya anomaliy refraktsii i akkomodatsii], 200.
2. 664c.VitVV (2003). The structure of the human visual system [Stroenie zritel’noy sistemy cheloveka], 664.
3. RozanovaOI, ShchukoAG (eds.) (2015). Presbyopia [Presbiopiya], 154.
4. RozanovaOI, MishchenkoOP, ShchukoAG (2012). Results of implantation of multifocal refraction intraocular lenses in patients with presbiopiya and cataract [Rezul’taty implantatsii mul’tifokal’nykh refraktsionnykh intraokulyarnykh linz u patsientov s presbiopiey i kataraktoy]. Prakticheskaya meditsina, 4-1(59), 295-298
5. BassamA, DonnenfeldE (2011). Bonus feature: IOL Explantation: indications and strategies for multifocal IOL explantation. Cataract and Refractive Surgery Today, (4), 18-20.
6. CharmanWN (2014). Developments in the correction of presbyopia I: spectacle and contact lenses. Ophthalmic Physiol. Opt., 34(1), 8-29
7. Datiles3rdMB, AnsariRR, SuhKI (2008). Clinical detection of precataractous lens protein changes using dynamic light scattering. Arch. Ophthalmol., 126(12), 1687-1693.
8. Fernández-BuenagaR, AlioJL, Muñoz-NegreteFJ (2012). Causes of IOL explantation in Spain. Eur. J. Ophthalmol., 22(5), 762-768
