In the next 10 years millions of patients will undergo refractive or cataract surgery. Increasingly we are seeing the merger of both as being intertwined. Corneal refractive surgery particularly for myopia is highly successful but hyperopia and presbyopia remains the challenge. The alternative is mainly clear lens exchange and multifocal IOL’s is clearly the better option. But this brings with it serious and potentially irreversible downside in a small percentage of patients including litigation. This is particularly a problem as many of the patients are young and active in the workplace. Whilst all procedures have risks, fixing some of the problems post lens exchange with multifocal IOL can be extremely challenging.
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