Clinical Results of Multifocal Intraocular Lenses
Some multifocal IOLs are designed to perform better for near vision; others, for intermediate. The performance targets of different multifocal IOLs is discussed in the section Modulation Transfer Function.
The best-corrected visual acuity (also called corrected distance visual acuity) may be less with a multifocal IOL than with a monofocal IOL; this difference increases in low-light situations. However, the need for additional spectacle correction for near vision is greatly reduced in patients with multifocal IOLs. Some patients are quite pleased with multifocal IOLs; others request their removal and replacement with monofocal IOLs. Interestingly, patients with a multifocal IOL in one eye and a monofocal IOL in the other often seem to be less tolerant of the multifocal IOLs than are patients with bilateral multifocal IOLs.
Patient selection is crucial for successful adaptation to multifocal IOLs. Selected patients must be willing to accept the trade-off—particularly in low-light situations—between decreased performance at distance vision (and at near vision, compared with that of a monofocal IOL and reading glasses) and the possibility of seeing well enough at all distances to be able to dispense with spectacles altogether. Patients with low contrast sensitivity function potential, such as those affected by glaucoma, retinal dystrophies, macular disease and advanced age, should be considered to be poor candidates for multifocal IOL implantation.
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Excerpted from BCSC 2020-2021 series : Section 3 - Clinical Optics. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.