Systematic Overview of Multifocal Intraocular Lenses

Abstract

Multifocal intraocular lenses (IOLs) are a safe and effective option to correct presbyopia though the methods of creating this multifocality have changed over the years. Currently, implanted lenses are mainly trifocal diffractive and Extended Depth of Focus (EDOF) IOLs. The analysis of the defocus curves of the different implants shows a comparable distance visual acuity, improved intermediate visual acuity with EDOF IOLs, and a better near visual acuity with tri- and panfocal IOLs. In cases where a patient has previously been treated with a monofocal lens or where there is doubt, a multifocal Add-on IOL (with the reassuring possibility of explantation if needed) can be considered if the patient wishes to be spectacle independent. Patient dissatisfaction results mainly from reduced visual acuity and optical phenomena such as halos and glare which are usually caused by residual refractive errors, secondary cataract, wide pupils in mesopic lighting conditions, dry eyes and IOL decentration. Spectacle-free vision is achieved in 49–100% of the cases; though this is more frequently seen with implantation of tri- and panfocal than EDOF IOLs.