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.
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References
Alio JL, Plaza-Puche AB, Férnandez-Buenaga R, Pikkel J, Maldonado M. Multifocal intraocular lenses: An overview. Surv Ophthalmol. 2017;62:611–34
de Vries NE, Nuijts RMMA. Multifocal intraocular lenses in cataract surgery: literature review of benefits and side effects. J Cataract Refract Surg. 2013;39:268–78.
Kohnen T, Herzog M, Hemkeppler E, Schönbrunn S, De Lorenzo N, Petermann K, Böhm M. Visual performance of a quadrifocal (trifocal) intraocular lens following removal of the crystalline lens. Am J Ophthalmol. 2017;184:52–62.
Kohnen T, Suryakumar R. Extended depth-of-focus technology in intraocular lenses. J Cataract Refract Surg. 2020;46:298–304.
Dick HB, Piovella M, Vukich J, Vilupuru S, Lin L. Prospective multicenter trial of a small-aperture intraocular lens in cataract surgery. J Cataract Refract Surg. 2017;43:956–68.
Jackson MA, Edmiston AM, Bedi R. Optimum refractive target in patients with bilateral implantation of extended depth of focus intraocular lenses. Clin Ophthalmol. 2020;14:455–62.
Cochener B. Clinical outcomes of a new extended range of vision intraocular lens: International Multicenter Concerto Study. J Cataract Refract Surg. 2016;42:1268–75.
Cochener B, Boutillier G, Lamard M, Auberger-Zagnoli C. A comparative evaluation of a new generation of diffractive trifocal and extended depth of focus intraocular lenses. J Refract Surg. 2018;34:507–14.
Vrijman V, van der Linden JW, van der Meulen IJE, Mourits MP, Lapid-Gortzak R. Multifocal intraocular lens implantation after previous corneal refractive laser surgery for myopia. J Cataract Refract Surg. 2017;43:909–14.
Vrijman V, van der Linden JW, van der Meulen IJE, Mourits MP, Lapid-Gortzak R. Multifocal intraocular lens implantation after previous hyperopic corneal refractive laser surgery. J Cataract Refract Surg. 2018;44:466–70.
Rosen E, Alió JL, Dick HB, Dell S, Slade S. Efficacy and safety of multifocal intraocular lenses following cataract and refractive lens exchange: Metaanalysis of peer-reviewed publications. J Cataract Refract Surg. 2016;42:310–28.
Böhm M, Petermann K, Hemkeppler E, Kohnen T. Defocus curves of 4 presbyopia-correcting IOL designs: Diffractive panfocal, diffractive trifocal, segmental refractive, and extended-depth-of-focus. J Cataract Refract Surg. 2019;45:1625–36.
Cao K, Friedman DS, Jin S, et al. Multifocal versus monofocal intraocular lenses for age-related cataract patients: a system review and meta-analysis based on randomized controlled trials. Surv Ophthalmol. 2019;64:647–58.
de Vries NE, Webers CAB, Touwslager WRH, Bauer NJC, de Brabander J, Berendschot TT, Nuijts RMMA. Dissatisfaction after implantation of multifocal intraocular lenses. J Cataract Refract Surg. 2011;37:859–65.
Woodward MA, Randleman JB, Stulting RD. Dissatisfaction after multifocal intraocular lens implantation. J Cataract Refract Surg. 2009;35:992–7.
Rosa AM, Miranda ÂC, Patrício MM, McAlinden C, Silva FL, Castelo-Branco M, Murta JN. Functional magnetic resonance imaging to assess neuroadaptation to multifocal intraocular lenses. J Cataract Refract Surg. 2017;43:1287–96.
Fernandez-Buenaga R, Alio JL, Perez AL, Quesada AL, Pinilla L, Barraquer RI. Resolving refractive error after cataract surgery: IOL exchange, piggyback lens, or LASIK. J Refract Surg. 2013;29:676–83.
Pinero DR, Ayala Espinosa MJ, Alio JL. LASIK outcomes following multifocal and monofocal intraocular lens implantation. J Refract Surg. 2010;26:569–77.
Xu J, Zheng T, Lu Y. Effect of decentration on the optical quality of monofocal, extended depth of focus, and bifocal intraocular lenses. J Refract Surg. 2019;35:484–92.
Qi Y, Lin J, Leng L, Zhao G, Wang Q, Li C, Hu L. Role of angle κ in visual quality in patients with a trifocal diffractive intraocular lens. J Cataract Refract Surg. 2018;44:949–54.
Hayashi K, Hayashi H, Nakao F, Hayashi F. Correlation between pupillary size and intraocular lens decentration and visual acuity of a zonal-progressive multifocal lens and a monofocal lens. Ophthalmology. 2001;108:2011–7.
Mesci C, Erbil H, Ozdoker L, Karakurt Y, Bilge AD. Visual acuity and contrast sensitivity function after accommodative and multifocal intraocular lens implantation. Eur J Ophthalmol. 2010;20:90–100.
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Müller-Kassner, A., Shajari, M. (2023). Systematic Overview of Multifocal Intraocular Lenses. In: Shajari, M., Priglinger, S., Kohnen, T., Kreutzer, T.C., Mayer, W.J. (eds) Cataract and Lens Surgery. Springer, Cham. https://doi.org/10.1007/978-3-031-05394-8_76
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