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Are you a good candidate for presbyopia correction during cataract surgery?

Whether or not to opt for presbyopia correcting lenses during cataract surgery is not a simple decision. With computers, cars, and just about anything else, paying extra money gets you something that pretty much everybody agrees is better. However, with presbyopia correcting lenses, the same surgical outcome can make one person ecstatic and another miserable. How is this possible?

The Four P’s

How happy you are likely to be with a multifocal depends on your "Four P’s": Personality, Physique, Pathology, and Predispositions. Let’s look at each of these in detail:


Good: relaxed, flexible, outgoing, positive, easy-going.

Bad: high strung, picky, particular, rigid, inflexible, easily upset.


Any physique works fine, but longer your arms are, the better. The lenses with the least side effects have a near focus that is a little further away than typical reading distance. These include the low power multifocals (ReSTOR 2.5, Tecnis 2.75) and EDOF lens (Symfony).

No Pathology

The best candidates for MF/EDOF lenses have healthy eyes and no history of corneal refractive surgery. Among other thins, this means: No history of corneal refractive surgery (LASIK, PRK, RK). No problems with the retina (such as macular degeneration and diabetic retinopathy). No problems with the optic nerve other than early and controlled glaucoma without visual field defects. No significant dry eye.

Correct Predispositions

How you like to spend your time matters. Patients who are most likely to be happy with presbyopia correcting lenses live active lives focused on sports, hiking, and seeing objects at a distance. They are less ideal for patients who spend all day on the computer or reading. If your calling in life is making jewelry, drawing, or carving, then the presbyopia correcting lenses may not be for you. Also, consider how important it is for you to be free of glasses for most tasks. If it is important, a few side effects may be a reasonable tradeoff for you.

If the 4P’s line up for you, then your chances of being happy with presbyopia correction are relatively high. If they don’t, and you still want presbyopia correction, be sure to discuss your options with your surgeon and openly address potential topics of concern prior to making a final decision.

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