Multifocal IOLs provide uncorrected distance visual acuity (UDVA) of 0.03 log MAR in 82.3%–95.7% of patients and overall spectacle independence in 81%–85% of patients.
Toric IOLs provide UDVA of 0.3 log MAR in 70%–95% of patients, residual astigmatism of 1 D or less is noted in 67%–88% of patients, and spectacle independence is reported in 60%–85% of patients.
For myopes and less risk-taking patients I prefer classical mini-monovision of 1.25D or EDOF IOLs with micro-monovision of 0.5D,” said Oliver Findl MD, of the Vienna Institute for Research in Ocular Surgery. These are especially effective in post LASIK, post RK eyes and in irregular corneal astigmatism.
The IC-8 IOL (Acu Focus) is a single-piece hydrophobic monofocal IOL that works similar to Kamra corneal inlay and uses the pinhole principle to increase depth of focus to about 3D.
Extended depth of focus (EDOF) IOLs are the latest variation in multifocal lens solutions. Peak resolution is only minimally affected, thereby giving reasonably clear vision at all distances with lesser glare and haloes or loss of contrast as compared to multifocals.
They are preferable over conventional multifocal IOLs in eyes with maculopathy, irregular corneas or glaucoma.
Therefore, it may be implanted in the dominant eye first followed by a micromonovision strategy with EDOF IOL or a multifocal in the non-dominant eye.
EDOFs like the Tecnis Symfony IOL (AMO) use a biconvex design, anterior aspheric surface, posterior achromatic diffractive surface with an echelette design to give better intermediate vision with less haloes and light scatter.
Future developments will potentiate development of new premium IOL designs that will provide spectacle independence and excellent visual outcomes after cataract surgery.Trifocals provide better intermediate vision with fewer side-effects by using second-order light diffraction and asymmetric light distribution. “I prefer the AT Lisa Trifocal and the Pan Optix IOL for correcting presbyopia.Both of these gave us good visual acuity for all distances and high patient satisfaction,” notes Tomas Kohnen MD, Professor and Chair, Department of Ophthalmology, Goethe University Frankfurt, Germany.Multifocal IOLs have two distinct foci with blurry vision in between.Focusing on one, may cause glare and haloes from the other.Synchrony Vu has a central blended aspheric zone to extend depth of focus.