Clinical use of multifocal and focus shift IOLs

Abstract

Abstract Purpose To compare the clinical experience with multifocal and focus shift IOLs in Austria, Germany and Spain. Methods We give a summary of published and unpublished data, reviews and meta‐analyses. Main outcome measures are uncorrected distance and near visual acuity, and reading speed under different light conditions as well as subjective patient satisfaction and spectacle independence. The focus will be on ReStor, ReZoom and Technis IOLs in the multifocal group, and ICU, BioComFold, AT‐45 Crystalens in the focus shift group. Results Multifocal IOLs can provide functional intermediate vision in bright light; under dim light the results vary depending on the IOL design. Hybrid design of the refractive‐diffractive IOL can reduce the increased optical aberrations induced by purely refractive multifocal IOLs. Aspheric apodized diffractive IOLs can reduce stray light artefacts and can enhance distance vision performance for large pupils. Focus shift IOLs result in a moderate to no improvement for uncorrected near visual acuity and minor or no forward movement, on average corresponding to less than 0.5 diopters. Conclusion Multifocal IOLs provide pseudo‐accommodation and their optical quality has improved due to new design developments. Focus shift IOLs accommodate only by a minor amount abd give some pseudo‐accommodation by mechanisms not clearly understood.