Multifocal Intraocular Lenses: Postimplantation Residual Refractive Error

  • Maja BohacEmail author
  • Ante Barisic
  • Sudi Patel
  • Nikica Gabric
Part of the Essentials in Ophthalmology book series (ESSENTIALS)


The meteoric technological advances and rapid shifts in the modes of practice have made cataract surgery a major form of refractive surgery. Modern microsurgical techniques, creative IOL technologies, sophisticated methods for biometry, and advanced methods of intraocular lens power calculation allow most cataract patients to regain high-quality vision. With the introduction of multifocal intraocular lenses (MIOLs), many patients request and expect total spectacle independence for all visual tasks. Overall, patient satisfaction scores after implantation of MIOLs are high. Satisfaction scores are closely linked to postop uncorrected distance, near and intermediate, visual acuity. There are various reasons that can lead to residual refractive error after the either clear lens exchange or cataract surgery (e.g. incorrect biometry methods, incorrect estimation of effective lens position and axial length measurement, surgically induced astigmatism, tilting or displacement of IOL). Strategies for correcting any residual refractive error include spectacle correction and contact lenses, corneal incisional procedures or enhancements with excimer laser (LASIK, PRK), conductive keratoplasty and lens based repeat surgery (IOL exchange, piggyback lenses).


Multifocal intraocular lenses Refractive lens exchange Presbyopia LASIK PRK 


Compliance with Ethical Requirements

Funding – No funding was received for this research.

Conflict of interest: All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria, educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent: Informed consent was obtained from all individual participants included in the studies.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Maja Bohac
    • 1
    Email author
  • Ante Barisic
    • 2
  • Sudi Patel
    • 3
  • Nikica Gabric
    • 1
  1. 1.Department of Cornea and Refractive SurgerySpecialty Eye Hospital Svjetlost, School of Medicine University of RijekaZagrebCroatia
  2. 2.Cataract DepartmentSpecialty Eye Hospital Svjetlost, School of Medicine University of RijekaZagrebCroatia
  3. 3.Specialty Eye Hospital Svjetlost, School of Medicine University of RijekaZagrebCroatia

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