Distance and near visual acuity improvement after implantation of multifocal intraocular lenses in cataract patients with presbyopia: a systematic review.

PURPOSE To evaluate uncorrected distance visual acuity (UDVA) as well as uncorrected near visual acuity (UNVA) as outcomes in treating presbyopic cataract patients to assist clinicians and ophthalmologists in their decision-making process regarding available interventions. METHODS Medline, Embase, and Evidence Based Medicine Reviews were systematically reviewed to identify studies reporting changes in UDVA and UNVA after cataract surgery in presbyopic patients. Strict inclusion/exclusion criteria were used to exclude any studies not reporting uncorrected visual acuity in a presbyopic population with cataracts implanted with multifocal intraocular lenses (IOLs). Relevant outcomes (UDVA and UNVA) were identified from the studies retrieved through the systematic review process. RESULTS Twenty-nine studies were identified that reported uncorrected visual acuities, including one study that reported uncorrected intermediate visual acuity. Nine brands of multifocal IOLs were identified in the search. All studies identified in the literature search reported improvements in UDVA and UNVA following multifocal IOL implantation. The largest improvements in visual acuity were reported using the Rayner M-Flex lens (Rayner Intraocular Lenses Ltd) (UDVA, binocular: 1.05 logMAR, monocular: 0.92 logMAR; UNVA, binocular and monocular: 0.83 logMAR) and the smallest improvements were reported using the Acri.LISA lens (Carl Zeiss Meditec) (UDVA, 0.21 decimal; UNVA, 0.51 decimal). CONCLUSIONS The results of this systematic review show the aggregate of studies reporting a beneficial increase in UDVA and UNVA with the use of multifocal IOLs in cataract patients with presbyopia, hence providing evidence to support the hypothesis that multifocal IOLs increase UDVA and UNVA in cataract patients.

[1]  H. C. Yang,et al.  Decentration, tilt, and near vision of the Array multifocal intraocular lens , 2000, Journal of cataract and refractive surgery.

[2]  M. Mesbah,et al.  Transforming scales of measurement of visual acuity at the group level , 2010, Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians.

[3]  K W Jacobi,et al.  Cataract extraction with multifocal intraocular lens implantation: Clinical, functional, and quality‐of‐life outcomes: Multicenter clinical trial in Germany and Austria , 2000, Journal of cataract and refractive surgery.

[4]  H. Bi,et al.  Early Clinical Evaluation of AcrySof ReSTOR Multifocal Intraocular Lens for Treatment of Cataract , 2007, Ophthalmologica.

[5]  M. Rękas,et al.  Multifocal diffractive intraocular lenses in cataract surgery--preliminary report. , 2006, Klinika oczna.

[6]  R. Bourne.  Uncorrected refractive error and presbyopia: accommodating the unmet need , 2007, British Journal of Ophthalmology.

[7]  B. Cochener,et al.  Corrected and Uncorrected Near and Distance Vision with ReSTOR® Compared to Monofocal Intraocular Lens Implantation after Cataract Surgery: A Pooled Analysis , 2008, Ophthalmologica.

[8]  O. Kermani,et al.  Dual intraocular lens implantation: Monofocal lens in the bag and additional diffractive multifocal lens in the sulcus , 2009, Journal of cataract and refractive surgery.

[9]  David P Piñero,et al.  Visual outcomes and optical performance of a monofocal intraocular lens and a new‐generation multifocal intraocular lens , 2011, Journal of cataract and refractive surgery.

[10]  M. Leyland,et al.  Multifocal versus monofocal intraocular lenses after cataract extraction , 2014, Sao Paulo medical journal = Revista paulista de medicina.

[11]  P. Chiam,et al.  Functional vision with bilateral ReZoom and ReSTOR intraocular lenses 6 months after cataract surgery , 2007, Journal of cataract and refractive surgery.

[12]  J. Vargas,et al.  Refractive outcomes after bilateral multifocal intraocular lens implantation , 2004, Journal of cataract and refractive surgery.

[13]  M. Holzer,et al.  Presbyopiekorrektur mittels Intraokularlinsen , 2006, Der Ophthalmologe.

[14]  A. Fimia,et al.  Double‐pass system analysis of the visual outcomes and optical performance of an apodized diffractive multifocal intraocular lens , 2010, Journal of cataract and refractive surgery.

[15]  Tina Callina,et al.  Traditional methods for the treatment of presbyopia: spectacles, contact lenses, bifocal contact lenses. , 2006, Ophthalmology clinics of North America.

[16]  Jorge L Alió,et al.  Clinical outcomes and intraocular optical quality of a diffractive multifocal intraocular lens with asymmetrical light distribution , 2008, Journal of cataract and refractive surgery.

[17]  M. J. Bautista,et al.  Visual outcomes after implantation of a refractive multifocal intraocular lens with a +3.00 D addition , 2010, Journal of cataract and refractive surgery.

[18]  L. Laatikainen,et al.  Quality of vision after AMO Array multifocal intraocular lens implantation , 2004, Journal of cataract and refractive surgery.

[19]  M. Chalita,et al.  Visual acuity, contrast sensitivity, reading speed, and wavefront analysis: pseudophakic eye with multifocal IOL (ReSTOR) versus fellow phakic eye in non-presbyopic patients. , 2006, Journal of refractive surgery.

[20]  T. Kohnen,et al.  Visual function after bilateral implantation of apodized diffractive aspheric multifocal intraocular lenses with a +3.0 D addition , 2009, Journal of cataract and refractive surgery.

[21]  J. Alió,et al.  Microincision multifocal intraocular lens with and without a capsular tension ring: Optical quality and clinical outcomes , 2008, Journal of cataract and refractive surgery.

[22]  L. Mastropasqua,et al.  Visual performance and biocompatibility of 2 multifocal diffractive IOLs: Six‐month comparative study , 2007, Journal of cataract and refractive surgery.

[23]  N Orzalesi,et al.  Performance of diffractive multifocal intraocular lenses in extracapsular cataract surgery , 1994, Journal of cataract and refractive surgery.

[24]  Ming Chen,et al.  A Comparison of a Monofocal Acrysoft IOL Using the “Blended Monovision” Formula with the Multifocal Array IOL for Glasses Independence After Cataract Surgery , 2007, Annals of ophthalmology.

[25]  S. Lane,et al.  Improvements in patient‐reported outcomes and visual acuity after bilateral implantation of multifocal intraocular lenses with +3.0 diopter addition: Multicenter clinical trial , 2010, Journal of cataract and refractive surgery.

[26]  U. Gunenc,et al.  Long-term experience with mixing and matching refractive array and diffractive CeeOn multifocal intraocular lenses. , 2008, Journal of refractive surgery.

[27]  Yücel Karakurt,et al.  Visual Acuity and Contrast Sensitivity Function after Accommodative and Multifocal Intraocular Lens Implantation , 2010, European journal of ophthalmology.

[28]  Newton Kara-Junior,et al.  A Contralateral Eye Study Comparing Apodized Diffrative and Full Diffrative Lenses: Wavefront Analysis and Distance and Near Uncorrected Visual Acuity , 2009, Clinics.

[29]  J Wollensak,et al.  A prospective evaluation of a diffractive versus a refractive designed multifocal intraocular lens. , 1997, Ophthalmology.

[30]  Thomas Kohnen,et al.  European multicenter study of the AcrySof ReSTOR apodized diffractive intraocular lens. , 2006, Ophthalmology.

[31]  Evolution of visual performance in 250 eyes implanted with the Tecnis ZM900 multifocal IOL. , 2009 .

[32]  Yang Zhou,et al.  Visual function after monocular implantation of apodized diffractive multifocal or single‐piece monofocal intraocular lens: Randomized prospective comparison , 2010, Journal of cataract and refractive surgery.

[33]  J T Holladay,et al.  Proper method for calculating average visual acuity. , 1997, Journal of refractive surgery.

[34]  S. Kurz,et al.  ReSTOR® Diffractive versus Array®2 Zonal-progressive Multifocal Intraocular Lens: a Contralateral Comparison , 2007, European journal of ophthalmology.

[35]  A. Reidy,et al.  Prevalence of serious eye disease and visual impairment in a north London population: population based, cross sectional study , 1998, BMJ.

[36]  R. Montés-Micó,et al.  Long‐term follow‐up of a multifocal apodized diffractive intraocular lens after cataract surgery , 2008, Journal of cataract and refractive surgery.

[37]  Fábio Canamary,et al.  Multifocal intraocular lens optic anteriorization capture to correct residual refractive error , 2009, Journal of cataract and refractive surgery.

[38]  Fred Hendrikse,et al.  Effectiveness of multifocal intraocular lenses to correct presbyopia after cataract surgery: a randomized controlled trial. , 2004, Ophthalmology.

[39]  Cem Mesçi,et al.  Visual performances with monofocal, accommodating, and multifocal intraocular lenses in patients with unilateral cataract. , 2010, American journal of ophthalmology.

[40]  T. Kohnen.  New abbreviations for visual acuity values. , 2009, Journal of cataract and refractive surgery.

[41]  Anthea M Burnett,et al.  Global vision impairment due to uncorrected presbyopia. , 2008, Archives of ophthalmology.

[42]  S. Gierek-Ciaciura,et al.  A comparative clinical study of the visual results between three types of multifocal lenses , 2009, Graefe's Archive for Clinical and Experimental Ophthalmology.

[43]  Béatrice Cochener,et al.  Clinical Ophthalmology Dovepress Comparison of Outcomes with Multifocal Intraocular Lenses: a Meta-analysis , 2022 .

[44]  A. Reidy,et al.  The deficit in cataract surgery in England and Wales and the escalating problem of visual impairment: epidemiological modelling of the population dynamics of cataract , 2000, The British journal of ophthalmology.