Presbyopia-correcting intraocular lenses and corneal refractive procedures: A review for retinal surgeons

Baseer U. Ahmad, Gaurav K. Shah, David R. Hardten

Research output: Contribution to journalReview articlepeer-review

6 Scopus citations


PURPOSE:: To review the specific challenges and pitfalls that vitreoretinal surgeons may face when operating on eyes with presbyopia-correcting intraocular lenses or previous corneal refractive surgery. In addition, this review aims to familiarize vitreoretinal surgeons with specifications of currently available Food and Drug Administration-approved presbyopia-correcting intraocular lenses. METHODS:: Review of current literature performed with PubMed for search terms "presbyopia," "correction," "IOL," "vitreoretinal," "challenges," and "surgical" both singly and in combination as well as closely related terms. RESULTS AND CONCLUSION:: Specific intraoperative issues with presbyopia-correcting intraocular lenses that may be encountered include peripheral visualization, condensation, lens material issues particularly with silicone oil, decentration, Z-syndrome, and foveal image displacement. Every patient undergoing retinal surgery should also be asked about previous laser-assisted in situ keratomileusis/photorefractive keratectomy because those eyes require special attention to surface hydration and care to avoid epithelial removal if possible. Intracorneal ring segments and corneal inlays can cause effects similar to those of a small pupil. However, these can be managed with thorough preoperative evaluation and various intraoperative maneuvers. In addition, retinal physicians should be aware that macular disorders, such as age-related macular degeneration, may be exacerbated by potential loss of contrast sensitivity.

Original languageEnglish (US)
Pages (from-to)1046-1054
Number of pages9
Issue number6
StatePublished - Jun 2014
Externally publishedYes


  • Challenges/complications
  • Contrast sensitivity
  • Corneal inlay
  • Decentration
  • Intraocular lens
  • Multifocal
  • Premium
  • Presbyopia
  • Vitrectomy
  • Vitreoretinal surgery
  • Z-syndrome


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