Monofocal lenses are the current standard of treatment, but usually require spectacles for near vision. The choice between the two types of lenses depends on patients' motivation to be free of glasses and contact lenses and on their having realistic expectations about the outcomes and compromises involved.
In this systematic literature review and meta-analysis of eight randomized controlled trials, the researchers examined a number of different outcomes: distance and near visual acuity, both unaided and corrected; spectacle independence; depth of field; contrast sensitivity; glare; subjective assessment of quality of life or visual function; and surgical complications.
Though there was significant variability in outcomes among the trials, in general it was found that distance acuity was similar in multifocal and monofocal intraocular lenses, and that unaided near vision tended to improve with the multifocal lens. Independence from spectacles was found in 26 percent to 47 percent of patients with multifocal lenses, but only in 1 percent to 11 percent of those with monofocal lenses. In addition, multifocal lenses increased depth of field. However, the multifocal lens also reduced contrast sensitivity and resulted in the subjective experience of seeing haloes around lights.
"This study is a very realistic interpretation of the multifocal versus monofocal tradeoff," said Academy spokesperson Samuel Masket, MD, clinical professor of ophthalmology at the Jules Stein Eye Institute, UCLA School of Medicine. "The key to choosing multifoca
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American Academy of Ophthalmology
23-Aug-2003