Multifocal versus monofocal intraocular lenses for age-related cataract patients: a system review and meta-analysis based on randomized controlled trials

Cao, Kai; Friedman, David S.; Jin, Songqing; Yusufu, Mayinuer; Zhang, Jingshang; Wang, Jinda; Hou, Simeng; Zhu, Guyu; Wang, Bingsong; Xiong, Ying; Li, Jing; Li, Xiaoxia; He, Hailong; Chai, Lijing; Wan, Xiu Hua

doi:10.1016/j.survophthal.2019.02.012

Cited by 89 publications

(67 citation statements)

References 48 publications

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“…5 In their meta-analysis, Cao et al found multifocal lenses provided better near and intermediate vision (both corrected and uncorrected). 8 However, patient-reported outcomes (PROs) have suggested more frequent dysphotopsia and worse contrast sensitivity, especially with low light or glare, with multifocal IOLs than with monofocal lenses. 4,[8][9][10][11][12][13] Glare and halo, caused by the transition zone between the diffractive steps, have been reported to cause patient dissatisfaction with multifocal lenses.…”

Section: Introductionmentioning

confidence: 99%

“…8 However, patient-reported outcomes (PROs) have suggested more frequent dysphotopsia and worse contrast sensitivity, especially with low light or glare, with multifocal IOLs than with monofocal lenses. 4,[8][9][10][11][12][13] Glare and halo, caused by the transition zone between the diffractive steps, have been reported to cause patient dissatisfaction with multifocal lenses. 9,12 IOLs with a decreased near addition (add) dioptric power have been suggested as a potential remedy for these unsatisfactory PROs.…”

Section: Introductionmentioning

confidence: 99%

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<p>Patient-Reported Outcomes/Satisfaction and Spectacle Independence with Blended or Bilateral Multifocal Intraocular Lenses in Cataract Surgery</p>

Hovanesian¹,

Lane²,

Allen³

et al. 2019

OPTH

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Purpose: To compare patient-reported outcomes (PROs) and satisfaction results after multifocal intraocular lens (IOL) implantation in three groups: two receiving bilateral implantation of the same IOL and another undergoing blended vision with two different multifocal IOLs. Patients and methods: A questionnaire was administered to patients who had undergone uncomplicated cataract surgery and 2 months of follow-up: the first group underwent bilateral implantation with Alcon's AcrySof ReSTOR 3.0 lens ("3.0/3.0," n=78); the second group underwent implantation with the ReSTOR ActiveFocus 2.5 or the ReSTOR ActiveFocus 2.5 toric lens ("2.5 mini-monovision," n=102); and the third group underwent implantation with the ReSTOR 2.5 lens in the dominant eye and the ReSTOR 3.0 lens in the non-dominant eye ("2.5/3.0," n=89). Results: Overall PROs and satisfaction was similar among the groups. Refractive outcomes and accuracy were similar among the groups, but the 2.5 mini-monovision group reported better intermediate vision. Refractive outcome differences were not meaningful among the groups and were not a differentiating factor in PROs. Substantially fewer patients in the 2.5 mini-monovision group noticed glare and halo compared with the 3.0/3.0 group (P<0.0001, chi-square test). No new safety concerns were reported. Conclusion: The 2.5 mini-monovision results in a higher percentage of patients being satisfied with intermediate vision than bilateral ReSTOR 3.0 or blended vision with ReSTOR 2.5/3.0 implants, but overall PRO differences were not statistically significant.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

<p>Patient-Reported Outcomes/Satisfaction and Spectacle Independence with Blended or Bilateral Multifocal Intraocular Lenses in Cataract Surgery</p>

Hovanesian¹,

Lane²,

Allen³

et al. 2019

OPTH

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“…We have read the article by Cao and coworkers, 1 and believe that some discussion is required. The authors compared the visual acuity, contrast sensitivity (CS) and adverse events in monofocal intraocular lenses and multifocal IOLs (MIOLs).…”

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confidence: 99%

“…The aim of this review was to assess high-quality evidence based on only randomized controlled trials (RCTs). 1 The risk of bias was assessed in several aspects as recommended by the Cochrane Collaboration;…”

mentioning

confidence: 99%

“…however, some studies included in the final analysis cannot be considered as RCTs; this was meticulously described in the Cochrane review on the same topic. 2 Four studies included in the meta-analysis by Cao and coworkers 1 were excluded from the Cochrane review as they were retrospective (Shah and coworkers, 2010), the participants were not randomly allocated to the intervention (Puell and coworkers, 2015, Maxwell and coworkers,2008) or because the Chinese-speaking Cochrane authors confirmed from the trialists that participants were not randomly allocated to the intervention (Ji and coworkers,. 2011).…”

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confidence: 99%

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Methodological challenges with randomized clinical trials for multifocal intraocular lenses

Tuuminen

Kanclerz²,

Grzybowski

2020

Survey of Ophthalmology

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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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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Multifocal versus monofocal intraocular lenses for age-related cataract patients: a system review and meta-analysis based on randomized controlled trials

Cited by 89 publications

References 48 publications

<p>Patient-Reported Outcomes/Satisfaction and Spectacle Independence with Blended or Bilateral Multifocal Intraocular Lenses in Cataract Surgery</p>

<p>Patient-Reported Outcomes/Satisfaction and Spectacle Independence with Blended or Bilateral Multifocal Intraocular Lenses in Cataract Surgery</p>

Methodological challenges with randomized clinical trials for multifocal intraocular lenses

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

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