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by I Howard Fine, Frank Joseph Goes, H Burkhard Dick, Michael C Knorz
Multifocal IOLs have been in the market since late 1980s, when the first diffractive and refractive IOLs were introduced. At that time, cataract surgery was mostly performed without capsulorhexis and with ECCE instead of phacoemulsification. The early multifocals were made from PMMA and required 6-7 mm incisions. The initial results were promising but there were also a lot of problems—mostly due to these surgical techniques. Since that time cataract surgery and MIOL implantation have changed dramatically. Cataract surgery had evolved in a quite safe procedure called refractive lens exchange. The different MIOLs have undergone extensive research and fine-tuning. All MIOLs are foldable, aspherical and well manufactured. More and more surgeons implant multifocal IOLs in their patients. Scientific knowledge has been accumulated in that how to select patients for IOL implantation (see several chapters in this book) and how to calculate the IOLs (Haigis). Nowadays, multifocal IOLs are implanted in almost every age group. Several chapters in this book will be referred to in this regard. Different designs and concepts (diffractive/refractive) are offered by the various companies. The combination of different MIOLs with different working principles (Mix and Match, Custom/Match) is at the moment part of the individualization of lens application. Multifocals have clear advantages over accommodative IOLs. The distant and near focus is fixed and the patient knows what he can expect. Even individual custom made implants with multifocal and toric components are now available and soon completely accessible. Multifocals are now really top products with more and more extrafeatures. Patient selection still remains the main issue for successful result. This book will help the surgeon understand the different types of MIOL and which MIOL is the best in what situation. The success of multifocal will not be in danger, as the accommodative IOLs are still not good enough to provide satisfactory near and distant vision. The editors of this book did a tremendous job to get an up-to-date overview on multifocals and future development.
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1. Fine I Howard
|Drs Fine, Hoffman and Packer, LLC, 1550-Oak St, Ste 5, Eugene, OR 97401, USA
2. Goes Frank Joseph
|Goes Eye Centre, W.Klooslaan 6 B2050, Antwerp, Belgium
3. Dick H Burkhard
|Centre for Vision Science, Ruhr University Eye Hospital, In der Schornau 23 - 25, 44892 Bochum, Germany
|4. Knorz Michael C
|Medical Faculty Mannheim of the University of Heidelberg, Theodor Kutzer Ufer 1-3, 68167 Mannheim, Germany
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