Abstract
In this report, we review the latest evidence for and against the use of premium intraocular lenses (IOL) in patients with glaucoma. Visual outcomes from clinical studies of newer Extend Depth of Focus (EDF) IOLs and low add apodized diffractive-refractive IOLs are significantly better than prior generations of multifocal (MF) IOLs. Clinical studies show that EDF and monofocal IOLs have similar contrast sensitivities in photopic conditions independent of spatial frequency. Premium IOLs restore uncorrected visual function, but intolerable visual disturbances and contrast impairment are uncommon side effects. Awareness of issues unique to glaucoma is critical for appropriate patient selection. Combined procedures with sizable shifts in IOP may have better refractive outcomes when staged. Toric and accommodating IOLs are reasonable options for most stages of glaucoma without fixation loss. EDF and newer MF IOLs can be appropriate options for stable pre-perimetric and early perimetric conditions.
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