Multifocality and focus shift IOLs ‐ theoretical aspects

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Abstract Purpose The purpose of this talk is to review the clinically relevant optical properties of multifocal and accommodative intraocular lenses and the potential visual consequences. The intention is to develop a fundamental understanding for clinicians and those working with them. Methods Critical evaluation of the optical, clinical and vision science literature. Topics covered will include principles of refractive and diffractive lenses, apodization, effect of pupil size, compromises in design, single and dual optic accommodative intraocular lenses, objective and subjective accommodation, depth of focus and theories of accommodation. Results Design of multifocal lenses involves a compromise in image quality that does not always manifest itself visually but can be measured optically. Accommodative intraocular lenses are limited in the amount of accommodation they can restore by the longitudinal shift in the lens and also post operative changes in the capsule. Changes in the radii of curvature of the lens surfaces are much more efficient at producing alterations in lens power. Conclusion All surgeons and associated workers need a knowledge of the optical principles of multifocal and accommodative intraocular lenses together with their visual consequences if they are to understand the cause of unwanted side effects. In addition, they will be better equipped to understand new developments in this rapidly changing field.