Cardiovascular effects and safety of mannitol in treating raised intraocular pressure

argued that even when severe, they cause very few person-years of morbidity if implanted in elderly patients. Multifocal lenses, however, are frequently implanted in middle-aged people, when the longer time in situ may result in more severe and significant grades of glistenings. Sometimes laser assisted enhancement is required in order to achieve optimal refractive outcome. This puts patients at risk of dry eye which will exacerbate the optical aberrations of a multifocal IOL if glistenings occur. Surgeons may reflect on the life expectancy of patients receiving these lenses as well as the increasing prevalence of dry eye with age. Non-chromophore lenses may be a prudent choice for young patients, particularly given the apparent absence of benefit found in recent major reviews. In the presence of severe glistenings, IOL exchange should be considered before a posterior capsulotomy is performed.