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Purpose: To evaluate the result of diffractive-refractive multifocal intraocular lens (IOL) implantation, regarding the visual acuity, spectacle independency, and also related disturbing visual pnenomenon such as halo and glare. Methods: Seventeen articles collected from multiple sources including Pubmed, Clinical Key, and Ophthalmology Advance were reviewed. Visual acuity. Five types of diffractive-refractive multifocal IOL were found including ReSTOR SA60D3, SN60D3, SA6AD3, SA6DA1, and AT Lisa 809M. Uncorrected and corrected visual acuity, spectacle independency and undesired visual phenomenon data of each IOL were analyzed. Results: For binocular uncorrected distance and intermediate vision, ReSTOR SN6AD1 is better than other IOL. Meanwhile, in binocular uncorrected near visual acuity category, ReSTOR SA60D3 is superior. Highest percentage of patients reporting spectacle independency found in ReSTOR SA60D3 group. Halo was found in each IOL group, ranged from 32 to 65 percent patients. Glare was found in a smaller percentage, ranged from 25 to 61 percent patients. Conclusion: The best option for patients aiming for best visual acuity in distance to intermediate activity without spectacle use is ReSTOR SN6AD1. Meanwhile, the best option for patients aiming for best near visual acuity is ReSTOR SA60D3. Comprehensive preoperative education is crucial, considering the cost and benefit aspects of multifocal IOL implantation.

Background Visual acuity (VA) assessment is an important ocular examination to identify children with vision problems. Such early identification allows for early intervention to prevent childhood blindness. Objective To describe and compare visual acuity measurements in preschool children using two different visual acuity charts. Methods This cross-sectional study in children aged 36-60 months was done in a low-income area in the Central Jakarta District as a collaboration between Department of Ophthalmology and Department of Child Health, Universitas Indonesia Medical School/Dr. Cipto Mangunkusumo Hospital, Jakarta. All children underwent visual acuity examinations using Lea symbols and Tumbling E charts. The VA results from two charts were analyzed with Bland-Altman plot for limits of agreement. Statistical analyses were performed to determine the differences between vision charts. Results A total of 113 children enrolled, but only 38 children completed the examinations. The mean age of subjects was 50.5 (SD 6.4) months. Overall, subjects’ mean VA was 0.29 (SD 0.18) for Lea symbols and 0.37 (SD 0.14) for Tumbling E. The mean difference of VA between Lea symbols and Tumbling E was 0.07 (SD 0.22) logMAR units, with upper and lower limits of agreement at 0.36 and 0.51, respectively. There was no statistical difference in VA score using Lea symbols and Tumbling-E based on gender and age. Conclusion Most preschool children in our study have normal visual acuity. Lea symbols and Tumbling E chart are comparable and can be used to efficiently measure VA in preschool children.