Multifocal versus monofocal intraocular lenses after                     cataract extraction

Calladine, Daniel; Evans, Jennifer R; Shah, Sweata; Leyland, Martin

doi:10.1590/1516-3180.20151331t2

Cited by 35 publications

(37 citation statements)

References 2 publications

(1 reference statement)

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“…Both groups performed relatively similar in obstacle clearance with no substantial differences. Our findings are consistent with the findings of Calladine et al, in which monofocal and multifocal IOLs were similar at all distances, except where multifocal IOLs improved near sight [28]. If both IOLs perform similarly at moderate visual distances, then it can be theorized that clearances would be similar.…”

Section: Monofocal Versus Multifocal Lensessupporting

confidence: 92%

Foot clearance and variability in mono- and multifocal intraocular lens users during stair navigation

2016

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Abstract-Intraocular lenses (IOLs) provide distance and near refraction and are becoming the standard for cataract surgery. Multifocal glasses increase the variability of toe clearance in older adults navigating stairs and increase fall risk; however, little is known about the biomechanics of stair navigation in individuals with multifocal IOLs. This study compared clearance while ascending and descending stairs in individuals with monofocal versus multifocal IOLs. Eight participants with multifocal IOLs (4 men, 4 women; mean age = 66.5 yr, standard deviation [SD] = 6.26) and fifteen male participants with monofocal IOLs (mean age = 69.9 yr, SD = 6.9) underwent vision and mobility testing. Motion analysis recorded kinematic and custom software-calculated clearances in threedimensional space. No significant differences were found between groups on minimum clearance or variability. Clearance differed for ascending versus descending stairs: the first step onto the stair had the greatest toe clearance during ascent, whereas the final step to the floor had the greatest heel clearance during descent. This preliminary study indicates that multifocal IOLs have similar biomechanic characteristics to monofocal IOLs. Given that step characteristics are related to fall risk, we can speculate that multifocal IOLs carry no additional fall risk.

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Section: Monofocal Versus Multifocal Lensessupporting

confidence: 92%

Foot clearance and variability in mono- and multifocal intraocular lens users during stair navigation

2016

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“…Lower contrast sensitivity and higher incidence of photic phenomena, such as halos and glare, have been reported with multifocal IOLs compared with monofocal IOLs, 3,10 despite good vision over a range of distances and spectacle independence achieved with multifocal IOLs. 14,15 At the 1-year follow-up visit of a randomized prospective clinical trial, halo and glare were reported to be more common with refractive multifocal IOLs compared with diffractive IOLs, and contrast sensitivity in patients with diffractive multifocal IOLs was similar or superior to that in patients who received monofocal IOLs or refractive multifocal IOLs.…”

Section: Discussionmentioning

confidence: 95%

“…Despite improvements in surgical techniques and outcomes, patients often require multifocal spectacles for near visual acuity and residual astigmatic error after surgery. 3 Postoperative dependence on vision correction is one of several factors that contribute to diminished vision-related quality of life after cataract surgery. The goal of this study was to evaluate and compare visual outcomes, spectacle independence, and quality of life among nonastigmatic and astigmatic patients who received AcrySof IQ ReSTOR toric or nontoric multifocal IOLs compared with those who received commercially available monofocal IOLs following bilateral cataract removal.…”

Section: Discussionmentioning

confidence: 99%

“…3,4 Astigmatism should be managed during cataract surgery and IOL implantation to minimize postoperative dependence on spectacles. 5 Incomplete restoration of visual acuity in patients implanted with monofocal or multifocal IOLs has been associated with limiting factors contributing to quality of life, such as reading and maintaining hobbies that require near vision.…”

Section: Multifocal Vs Monofocal Iols/shah Et Almentioning

confidence: 99%

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Visual Outcomes After Cataract Surgery: Multifocal Versus Monofocal Intraocular Lenses

Shah¹,

Peris-Martínez²,

Reinhard³

et al. 2015

J Refract Surg

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ataract is a common, vision-altering condition that affects 36 million people in Western Europe and is projected to affect approximately 30 million people in the United States by the year 2020.1 Implantation of a monofocal intraocular lens (IOL) after surgical removal of cataract via phacoemulsification is the standard of care in the Western world.2 Although monofocal IOLs result in excellent distance acuity, patients usually require corrective spectacles C ABSTRACT PURPOSE: To evaluate visual outcomes, spectacle independence, and quality of life among nonastigmatic and astigmatic patients who received AcrySof IQ ReSTOR toric or nontoric multifocal intraocular lenses (IOLs) (Alcon Laboratories, Fort Worth, TX) compared with those who received commercially available nontoric monofocal IOLs after bilateral cataract removal. METHODS:This randomized, patient-and observertechnician-masked study was conducted at 20 sites in Europe. Patients were randomized to receive monofocal (nontoric only) or multifocal (nontoric or toric, as needed) IOLs. Primary efficacy endpoints included percentage of patients achieving binocular uncorrected distance and near acuity of 0.1 logMAR or better (20/25 Snellen), spectacle independence, and scores on the National Eye Institute Refractive Error and Quality of Life questionnaire domains. Safety endpoints included adverse events and refractive error within 0.5 and 1.0 diopters. RESULTS:In the multifocal group (n = 108) versus the monofocal group (n = 100), significantly more patients achieved uncorrected distance and near acuity of 0.1 logMAR or better (45.7% vs 2.1%; P < .0001) and spectacle independence (73.3% vs 25.3%; P < .0001) at 6 months. The percentage of patients who achieved uncorrected distance visual acuity of 20/40 or better at 6 months was 92% in the multifocal group and 97% in the monofocal group. National Eye Institute Refractive Error and Quality of Life scores were significantly better for dependence on correction in the multifocal group (P < .0001) and for glare in the monofocal group (P = .0157); other domain scores were similar between groups. No significant trends in study device-related adverse events were observed. CONCLUSIONS:Monofocal and multifocal IOLs provided good clinical outcomes. More patients receiving multifocal IOLs attained better uncorrected visual acuity at a range of distances and spectacle independence compared with patients who received monofocal IOLs. Monofocal IOLs were associated with better patientreported scores for glare compared with multifocal IOLs; however, scores for patient satisfaction were significantly better in the multifocal group.[J Refract Surg. 2015;31(10):658-664.]

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“…[1][2][3] In cataract surgery, multifocal IOL implantation substantially solved the problem of near vision without eyeglasses and without impairing distance vision, which could not be achieved with classical monofocal IOLs. [4][5][6] However, it was reported that depth of focus reduces and problems such as blurred vision, photophobia, halo and glare are more prevalent in the patients that underwent multifocal IOL implantation and have uncorrected corneal astigmatism of 0.75 diopter and over. [7][8][9] In addition to correction of refractive defect and enabling near vision without the need for eyeglasses, also correction of astigmatism has been possible with multifocal toric IOL that has been manufactured recently.…”

Section: Introductionmentioning

confidence: 99%

Comparison between clinical outcomes of two different designs of toric multifocal intraocular lenses

Ayar¹,

Özmen²,

Yazgan³

et al. 2017

Med-Science

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To compare the clinical outcomes of plate haptic and open-loop haptic toric multifocal intraocular lenses (IOLs). In this retrospective, comparative clinical trial, two different designs of multifocal toric IOL were implanted in 49 eyes of 38 cases with corneal astigmatism ≥ 0.75 Diopter (D). The cases that underwent AcrySof IQ restore multifocal toric IOL (Alcon, open-loop-haptic) implantation were assigned to Group1 (n=19) and the cases that underwent Acriva Reviol multifocal toric IOL (VSY, plate-haptic) implantation were assigned to Group 2 (n=30). After surgery, the groups were compared in terms of degree of IOL rotation, residual spherical refraction and astigmatism and uncorrected near and distance visual acuity. With regard to the results of postoperative 1st month, 3rd month, 6th month and 1st year, no difference was determined in terms of uncorrected distance visual acuity, spherical equivalent (SE), degree of astigmatism (CYL), degree of rotation, and uncorrected near visual acuity (p>0.05). Significant increase was determined in all postoperative follow-up periods in terms of the distance and near visual acuity as compared to preoperative values (p<0.05). There was no correlation between degree of rotation and age, axial length, SE and CYL (p>0.05). Clinical outcomes of plate haptic Acriva Reviol multifocal toric IOL and open-loop haptic Acrysof IQ multifocal toric IOL are similar. Both types of IOL effectively reduce astigmatism and provide satisfactory uncorrected distance and near visual acuities.

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Multifocal versus monofocal intraocular lenses after cataract extraction

Cited by 35 publications

References 2 publications

Foot clearance and variability in mono- and multifocal intraocular lens users during stair navigation

Foot clearance and variability in mono- and multifocal intraocular lens users during stair navigation

Visual Outcomes After Cataract Surgery: Multifocal Versus Monofocal Intraocular Lenses

Comparison between clinical outcomes of two different designs of toric multifocal intraocular lenses

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