EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/880217
121 EW RESIDENTS October 2017 Review of "Functional magnetic resonance imaging to assess neuroadaptation to multifocal lenses: a longitudinal study" M odern multifocal IOLs offer an appealing op- tion for patients who desire spectacle-free distance and near vision following cataract surgery. Multifocal lenses can be refractive, diffractive, or accommodating and utilize optical properties to create a wider range of focus or two separate focal points. Inherent in the com- plex optical design of these lenses is the increased presence of positive dysphotopsias including glare and halos, as well as decreased contrast sensitivity. While multifocal lens implanta- tion results in higher rates of spec- tacle-free vision, patients also report higher incidences of dysphotopsia symptoms. 1 Most patients tolerate this visual compromise, but for a mi- nority, visual quality is significantly affected. These symptoms are the most common reason for surgical explantation of multifocal lenses. 2,3 It is not clear why some patients have a more severe decline in their quality of vision with a multifocal lens than other patients. Many spec- ulate that it is related to poor neu- roadaptation by a subset of patients Summary "Functional magnetic resonance imaging to assess neuroadaptation to multifocal intraocular lenses: to visual compromises inherently present with these lenses. Functional magnetic resonance imaging (fMRI) has previously been used to assess neuroadaptation to refractive chang- es. 4 This paper utilizes this imaging technique to assess neuroadaptation to multifocal intraocular lenses. Tara Uhler, MD, director of resident education, Wills Eye Hospital Do dysphotopsias from diffractive IOLs really improve due to neuro- adaptation, or do patients simply grow tired of complaining? I asked the Wills Eye residents to review an interesting study on neuroadap- tation that appears in this month's issue of JCRS. —David F. Chang, MD, EyeWorld journal club editor by Michael Abendroth, MD, MBA, Phoebe Mellen, MD, Martha Ryan, MD, Rebecca Soares, MD, and J. David Stephens, MD continued on page 122