Multifocal and Extended Depth-of-Focus Intraocular Lenses in 2020

Rampat, Radhika; Gatinel, Damien

doi:10.1016/j.ophtha.2020.09.026

Cited by 170 publications

(168 citation statements)

References 77 publications

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“…As the pupillary size changes, the number of zones that are utilized varies, and, subsequently, the relative proportion of light directed to the distant, near and/or intermediate focal points changes as well [59]. Thus, image quality can fluctuate depending on pupil size [61,62].…”

Section: Fully Refractive Iolsmentioning

confidence: 99%

“…To create multifocality, diffractive multifocal IOLs use the optical phenomenon of diffraction and take advantage of the wave nature of light by selectively delaying the optical path in selected areas and slightly changing its direction when encountering an edge or discontinuity [59][60][61][62]. Typical diffractive multifocal IOLs consist of concentric annular zones in their anterior or posterior surface that constitute an asymmetrical zone plate, also referred as "diffractive kinoform" (Figure 2) [63].…”

Section: Diffractive Iolsmentioning

confidence: 99%

“…These microscopic steps on the diffractive surface of the IOL with height of a few microns have a specific phase delay. The area of each zone determines the add power of the IOL and the maximum height of the steps determines the relative amount of light energy distributed on each focus [60,61]. In fact, the heights of each step are chosen in such a way that approximately 40 -40.5% of the incident light contributes to the add portion, 40 -40.5% of the incident light contributes to the distance portion and the remaining light goes into other diffractive foci.…”

Section: Diffractive Iolsmentioning

confidence: 99%

“…Alternative step heights can be chosen to shift more energy to either the distance or near focus. Therefore, the diffractive element of these IOLs enables the splitting of the incoming light into two or three foci for bifocal and trifocal IOLs, respectively [60,61]. A further division of diffractive multifocal IOLs is based on apodization, which is the gradual decrease of the height of the steps from the center of the optic to its periphery [61].…”

Section: Diffractive Iolsmentioning

confidence: 99%

“…Therefore, the diffractive element of these IOLs enables the splitting of the incoming light into two or three foci for bifocal and trifocal IOLs, respectively [60,61]. A further division of diffractive multifocal IOLs is based on apodization, which is the gradual decrease of the height of the steps from the center of the optic to its periphery [61]. Thus, diffractive IOLs can be classified into those with apodized and those with non-apodized diffractive optics (Figure 3).…”

Section: Diffractive Iolsmentioning

confidence: 99%

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Pseudophakic Presbyopic Corrections

Labiris¹,

Panagiotopoulou²

2021

Current Cataract Surgical Techniques

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Presbyopia is a prevalent productivity-reducing, age-related visual disorder that results in a progressive near vision impairment. Conventional treatment modalities (ie. presbyopic spectacles or contact lenses) are associated with poor acceptance, productivity loss and negative impact on life quality. However, a variety of surgical methods are available to address presbyopia; among them, multifocal and multifocal toric intraocular lenses (IOLs) and monovision techniques. For the best possible refractive outcomes, the overall management of presbyopic patients is necessary. Specifically, patient selection according to personality and daily activities, topography, aberrometry, astigmatism, pupil and fundus assessment, ophthalmic surface, and premium lens selection should be taken into consideration. Additionally, image-guided surgery could increase the accuracy in multifocal/multifocal toric IOL implantation, and optimize the refractive outcome increasing patient satisfaction. Primary objective of this chapter is to analyze the fundamental preoperative, intraoperative and postoperative management of patients that undergo pseudophakic presbyopic corrections with conventional or digital-marking assisted techniques.

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Section: Fully Refractive Iolsmentioning

confidence: 99%

Section: Diffractive Iolsmentioning

confidence: 99%

Section: Diffractive Iolsmentioning

confidence: 99%

Section: Diffractive Iolsmentioning

confidence: 99%

Section: Diffractive Iolsmentioning

confidence: 99%

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Pseudophakic Presbyopic Corrections

Labiris¹,

Panagiotopoulou²

2021

Current Cataract Surgical Techniques

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Visual Outcomes and Optical Quality of Accommodative, Multifocal, Extended Depth-of-Focus, and Monofocal Intraocular Lenses in Presbyopia-Correcting Cataract Surgery

et al. 2022

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ImportanceA bayesian network meta-analysis (NMA) can help compare the various types of multifocal and monofocal intraocular lenses (IOLs) used in clinical practice.ObjectiveTo compare outcomes of presbyopia-correcting IOLs frequently recommended in clinical practice through a bayesian NMA based on a systematic review.Data SourcesMedline (PubMed) and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched on May 15, 2021, from inception.Study SelectionBased on the research question, randomized clinical trials assessing multifocal IOLs in patients who underwent bilateral cataract extraction were searched. Nonrandomized studies, studies in patients with unilateral or contralateral cataract extractions, duplicated studies, conference abstracts, and nonpeer-reviewed articles were excluded.Data Extraction and SynthesisDescriptive statistics and outcomes were extracted. The NMA was conducted to compare different types of IOLs. The mean differences for continuous variables, odds ratios for binary variables, 95% credible intervals (CrIs), and ranks of interventions were estimated.Main Outcomes and MeasuresThe outcomes examined included binocular visual acuities by distance and optical quality, including glare, halos, and spectacle independence.ResultsThis NMA included 27 studies comprising 2605 patients. For uncorrected near visual acuity, trifocal IOLs (mean difference, −0.32 [95% CrI, −0.46 to −0.19]) and old bifocal diffractive IOLs (mean difference, −0.33 [95% CrI, −0.50 to −0.14]) afforded better visual acuity than monofocal IOLs. Regarding uncorrected intermediate visual acuity, extended depth-of-focus IOLs provided better visual acuity than monofocal IOLs. However, there were no differences between extended depth-of-focus and trifocal diffractive IOLs in pairwise comparisons. For uncorrected distant visual acuity, all multifocal IOLs were comparable with monofocal IOLs. There were no statistical differences between multifocal and monofocal IOLs regarding contrast sensitivity, glare, or halos.Conclusions and RelevanceFor patients considering a multifocal IOL due to presbyopia, bilateral implantation of a trifocal IOL might be an optimal option for patients without compromising distant visual acuity.

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