Presbyopic IOLs: Accommodative and Pseudo-types

Presbyopia is a major refractive challenge for the coming decades. A variety of surgical procedures like scleral expansion, zonal photorefractive keratectomy, and corneal inlay implantation have been investigated none have yet gained popular acceptance. Implantation of intraocular lenses (IOLs) at the time of cataract surgery or refractive lens exchange provides another opportunity to tackle the presbyopia challenge. A simple kind of postoperative multifocality, i.e., myopic astigmatism, has long been recognized as a favorable refractive outcome as it creates “pseudo accommodation”. An apparent accommodative behavior was also attributed to conventional monofocal IOLs. These observations set the stage for the development of accommodative and then multifocal IOLs (MFIOLs). Popular FDA-approved brands of such IOLs include Crystalens HD (Bausch Lomb), TECNIS (AMO), ReZoom (AMO), and AcrySof ReSTOR (Alcon)