Ophthalmic Technology Assessment: Multifocal and Accommodating Intraocular Lenses for the Treatment of Presbyopia A report by the American Academy of Ophthalmology.

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To review the published literature assessing the efficacy and safety of presbyopia-correcting intraocular lenses (IOLs) for the treatment of presbyopia after cataract removal.Literature searches were undertaken in January 2018 and September 2019 in the PubMed, Medline, Food and Drug Administration and Cochrane Library databases. This yielded 761 articles, of which 34 met the criteria for inclusion in this assessment and were assigned a level of evidence rating by the panel methodologist. Thirteen studies were rated level I and 21 studies were rated level II.Presbyopia-correcting lenses were effective at improving distance and near visual acuity after cataract surgery. Near acuity at different focal lengths was directly related to the effective add power of multifocal and extended depth of focus (EDOF) IOLs. Most multifocal and EDOF lenses that were compared with a control monofocal lens demonstrated that patient-reported spectacle independence was superior to the monofocal. All subjects who had multifocal and EDOF lenses implanted had decreased contrast sensitivity and reported more visual phenomena as compared with monofocal controls.Presbyopia-correcting lenses improve uncorrected near and distance visual acuity and decrease spectacle dependence after cataract surgery. Mesopic contrast sensitivity is decreased compared with monofocal lenses, and patient-reported visual phenomena are more likely in patients receiving multifocal or EDOF lenses.

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Authors: Julie M Schallhorn, Seth M Pantanelli, Charles C Lin, Zaina Al-Mohtaseb, Walter Allan Steigleman, Timothy W Olsen, Stephen J Kim, Aaron M Waite, Marcony R Santhiago