Presbyopia Correction in Lens Replacement Surgery: A Review.

Abstract

Presbyopia affects approximately 1.8 billion individuals globally, posing significant challenges as life expectancy and near-vision demands, particularly with mobile phone use, grow. Addressing presbyopia during lens replacement surgery has become a key focus for cataract surgeons, aiming to reduce dependence on corrective eyewear. This review provides an overview of current intraocular lens (IOL) technologies and surgical strategies for presbyopia correction. Personalised decision-making is essential, considering each patient's visual needs, expectations, and ocular anatomy. Partial correction approaches, such as monovision and extended depth-of-focus IOLs, can improve intermediate vision but involve specific trade-offs compared to monofocal lenses, depending on the technology utilised. For complete presbyopia correction, multifocal IOLs remain the most effective option. A mix-and-match strategy involving unilateral multifocal implantation shows promise, while sulcus-fixated supplementary IOLs offer the advantage of easier reversibility. Careful IOL selection is particularly important for patients with atypical ocular anatomy or coexisting conditions, which may be progressive.