Neuroadaptation to multifocal intraocular lenses: A new approach to solving the problem

Abstract

The current trend towards the implantation of multifocal intraocular lenses is associated with the desire of patients to be independent of glasses and improve the quality of life. However, the brain in conditions of multifocal correction of aphakia works with several foci, which is unphysiological, energy-consuming and requires long-term neuroadaptation. With the depletion of brain resources in adulthood due to problematic neuroadaptation to multifocal intraocular lenses, the neuropsychic or somatic health of patients may deteriorate. The eye-brain system is evolutionarily adapted to aberrations within 1.5 diopters. It is proposed to form direct simple myopic astigmatism up to 1.5 diopters during monofocal correction of aphakia (by laser correction of corneal refraction or implantation of a spherical cylindrical intraocular lens). The specified refraction, expanding the focal area of the pseudophakic eye, provides the greatest (in comparison with other types of refraction) amount of pseudo-accommodation and, accordingly, independence from glasses. The proposed approach is physiological for the brain and does not cause problems with neuroadaptation.

Age maculodystrophia: the hypothesis of etiopathogenesis

“…Expansion of the ring of the ciliary body by forming supraciliary non-penetrating sclerectomies (imitation of anterior staphyloma of the sclera: 16 II. If cataract surgery is necessary: calculate the optical power of the IOL in such a way that the final refraction of the eye is simple myopic direct-type astigmatism up to 1.5 diopters (which provides the largest volume of pseudoaccommodation); 17 in some cases (when the eye is already artificial), the specified refraction can be achieved by modeling the corneal surface with a femtosecond laser.…”