Surgical Correction of Presbyopia

Lenticular, Corneal, and Scleral Approaches

Michael Greenwood, MD; Shamik Bafna, MD; Vance Thompson, MD


Int Ophthalmol Clin. 2016;56(3):149-166. 

In This Article

Bifocal IOLs

Apodized IOLs have a gradual reduction in diffractive step heights from the center to the periphery.[60] This allows for more light to contact the smaller steps in the periphery when the pupil is dilated. An example of an apodized lens is the AcrySof ReSTOR by Alcon (Fort Worth, TX). This IOL is a single-piece, foldable, hydrophobic acrylic, apodized, diffractive posterior chamber IOL with 2 versions available in the United States: a +3.0 D power lens that is +2.5 D at the spectacle plane and a +2.5 D lens that is +2.0 D at the spectacle plane. There is a toric version of this IOL available in Europe, but not yet in the United States.

Nonapodized diffractive multifocal IOLs use uniform height diffractive steps, which directs equal amounts of light to near and distant focal points for all pupil sizes.[60] An example of a nonapodized lens is the Tecnis multifocal IOL platform from AMO (Santa Ana, CA). The Tecnis IOL has the nonapodized diffractive steps on the posterior side of the lens, compared with the Alcon lens, which places them on the anterior portion. This platform has 3 versions available in the United States. The ZKBOO, ZLBOO, and ZMBOO provide +2.75, +3.25, and +4.0 D of power in the lens resulting in+2.01, +2.37, and +3.0 D of power at the spectacle plane, respectively.