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  • Part A photograph courtesy of Kenneth J. Hoffer, MD; part A, B, C illustrations redrawn by C. H. Wooley; part D and E illustrations courtesy of Mark Miller.
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    Refractive Mgmt/Intervention

    Multifocal IOLs. A, Hoffer split bifocal IOL (left) and an early photograph of a lens implanted in a patient (right). B, Three-zone multifocal design. C, Diffractive multifocal IOL; the cross-section of the central portion is magnified. (The depth of the grooves is exaggerated.) Note that the diffractive element may be on the anterior or posterior aspect of the optic. D, Diffractive optics of a multifocal (bifocal) IOL. Note the unfocused light rays hitting the retina, which can contribute to dysphotopsias.E, Multifocal IOL.