The role of neuroadaptation in lens surgery with multifocal intraocular lens implantation

In the modern world the refusal of spectacle correction for near vision due to the development of presbyopia after 40 years old is an increasingly common criterion of satisfaction among patients, especially those leading an active lifestyle and wishing to solve the problem by surgical methods. The only effective method of correcting this condition is multifocal intraocular correction. Although the majority of patients do not require spectacles or contact lenses after this type of surgery, every surgeon with an active surgical practice has a number of patients who are dissatisfied with their outcomes. This may occur both as a result of complications during surgical treatment, and due to the peculiarities of neuroadaptation processes, the state of brain plasticity in each individual patient. The most common complications of multifocal correction are blurred vision and the presence of optical phenomena (halo and glare) associated with residual ametropia, posterior capsule opacification, large pupil size, wavefront anomalies, dry eye and lens decentration. The main causes of this are lens dislocation, residual refractive error, lens opacification and disruption or difficulty of the patient’s neuroadaptation process. Understanding and assessing the neuroadaptation in patients who have undergone lens surgery to correct presbyopia and eliminate cataracts is a poorly studied aspect of cataract surgery in the CIS countries and somewhat more studied in foreign literature, which is a promising direction for research. This article will review the literature on the above topic.