• Are there any multifocal or accommodating IOLs that would be OK to use with Duane Syndrome?


    Question:

    I am 64 and have accommodated quite well to living with Duane Syndrome (an eye muscle disorder). I need cataract surgery and have been told that I must have the monofocal (set for distance) IOL. Are there any multifocal or accommodating IOLs that would be OK to use with Duane Syndrome?

     


    Answer:

    That is a very tough question. There are two different companies that manufacture multifocal implants in the USA. They have been proven as safe and effective in their clinical trials. These clinical trials did not include any patients with eye muscle problems such as yours. That means that the use of a multifocal lens in your case would be "off label" and not proven to be safe and effective.

    That being said, it is possible for you and your doctor to take a risk and do your cataract surgery "off label," but the manufacturer would not be responsible for any problems you have such as double vision. Additionally the surgeon would likely require you to release him/her from any responsibility for any visual difficulties you might have. It could be necessary to have a second operation to remove the multifocal lens and replace it with a conventional lens.

    Lastly, your insurance company might refuse to pay for the first surgery declaring it to be experimental/investigational as it is not approved by the FDA in your case, and or, they might refuse to pay for a second surgery if the multifocal lens didn't work out properly. It seems to me that there is too much risk for too little benefit to my way of thinking. I urge you to discuss this issue at length with your ophthalmologist.


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