During the last decade multifocal intraocular lenses (IOL) became widely used in cataract surgery and proved to be effective in recovery of visual functions. Lots of clinical studies with different multifocal IOL models showed high effectiveness of multifocal correction to achieve good visual quality for far, intermediate, and near distances. Uncorrected visual acuity at a distance is equal to multifocal and monofocal correction, while uncorrected near vision is significantly better with multifocal IOLs. Additional segment position in asymmetric multifocal IOL models did not significantly influence on visual acuity. Multiple multifocal IOL designs (bifocal, trifocal) and ADD power level provide different functional results for near and intermediate distances which allows to select the specific IOL model depending on the patient`s needs. The review covers the following aspects of multifocal intraocular correction: update for classification of multifocal IOLs, visual acuity (functional results) at different distances after multifocal IOL implantation, comparison of clinical results with different multifocal IOL designs and add power levels, influence of add segment position in asymmetric multifocal IOLs on visual quality, comparison between multifocal and monofocal correction.

The core target of multifocal IOLs implantation is to provide advanced visual quality at different distances without spectacle or contact lenses that can be valuable when monofocal IOLs are implanted. Patients with monofocal IOLs need spectacles or contact lenses for the near and intermediate distance's vision. Multifocal intraocular lenses due to the optical part construction provide spectacle independence for patients in the postoperative period. The aim of this review was to analyze the modern approach to the several aspects of multifocal intraocular correction: spectacle independence, dysphotopsia, patient satisfaction. Patients’ questionnaire after surgery provides the data for evaluation of the quality of life, vision satisfaction at all range of distances on different levels of illumination, and patient activities of daily living. During the long period, a photic phenomenon (dysphotopsia) had been discussed in the literature as the principal reason for decrease of patients satisfaction with the treatment and lens explantation. Recently, high grade of spectacle independence and low risk of photic phenomena after modern multifocal IOLs implantation determine high-level patient satisfaction after cataract surgery. Multifocal intraocular correction is the effective technology for restoring passive accommodation that the wide range of the clinical studies proved. This review analyzes 33 studies (32 clinical studies and 1 metaanalisis) published in international peer-reviewed targeted titles.

There are some multufocal intraocular corrections particular qualities compared to monofocal correction. Therefore, the patient’s careful selection, detail preoperative diagnosis, accurate intraocular lens power calculation are necessary to get the optimal clinical results. There are some disadvantages in the postoperative period, such as the contrast sensitivities reduction, dysphotopsia, neuroadaptation. In addition multifocal IOLs are expensive. The clinical studies include evaluating of visual acuity for different distances, defocus curve, spectacle independence, contrast sensitivity, aberrometry data. Additionally, complications after multifocal IOLs implantation and the reasons of explantation are analyzed. This review includes 36 articles (34 clinical studies and 2 meta-analysis) of the following aspects of multifocal intraocular correction: contrast sensitivity, aberrometry analysis, pupil influence on the visual outcomes, postoperative complications, analysis of explantation reasons, preoperative patient’s selection for multifocal correction.

No abstract