He first visited us with reduced vision from an advanced nuclear cataract in one eye. He works as a magazine editor and enjoys diving and photography as hobbies, and wished for surgery with a multifocal lens that put quality of vision first, regardless of coverage by advanced medical care. We therefore recommended MiniWELL Ready or the trifocal AcrivaUD Trinova. The difference between them is that MiniWELL has fewer halos and glare, while Trinova gives better near vision; after discussion he chose MiniWELL, and agreed to setting it slightly near-dominant so as not to hinder his work.
His axial length exceeded 32 mm (the Japanese average is just under 24 mm) and his refraction was extreme myopia beyond −15 D, so the likelihood of postoperative refractive error (intraocular lens power deviation) was very high. Also, in our experience, people with high myopia, that is, long eyes, show a gap between objective refraction (measured by machine) and subjective refraction (the glasses power with which they subjectively see best), so even when the result matches the calculation, subjective vision is sometimes not quite right. So this time, in addition to the latest power formulas, we decided the lens power using an AI (artificial intelligence) formula and our own regression formula prioritizing subjective refraction, built from cases of eyes longer than 30 mm at the university hospital and our clinic; as a result he was very satisfied with very good uncorrected vision of 1.2 at distance and 1.2 at near. Had we chosen the power from the other formulas' results, he would have become hyperopic with poor near vision, which would have hindered his work.
Surgery on long eyes, that is, high myopia, carries not only surgical risks such as weak zonules but also a very high risk of refractive error, making these difficult cases in which the surgeon cannot relax just because the operation went well. Our clinic, for multifocal and monofocal lenses alike, proposes appropriate powers suited to each patient's lifestyle based on repeated test results and our record and experience, so please feel free to consult us.
2019.3.15