Multifocal IOLs – Clinical Indication and Pearls for Successful Application and Clinical Results

Cataract surgery has undergone dramatic improvements, rehabilitation is quick, the complication rate is decreasing, IOL material and calculations have improved, and excellent uncorrected distance visual acuity can be expected in most cases where the eye is healthy. Currently, one of the major challenges of cataract surgery is presbyopia correction. Patients expect excellent distance vision, as well as spectacle freedom for near vision. Multifocal IOLs, better termed bifocal IOLs, and recently trifocal IOLs, create 2 or 3 foci. These IOLs have improved in recent years and can provide a good solution for those who seek to reduce spectacle dependency. However, the downside to these IOLs includes halo, glare and reduced distance vision contrast sensitivity. In this chapter, we will review the basic principles of multifocal IOLs and their clinical results. It is worthy to note that currently only the Alcon AcrySof ReSTOR (Fort Worth, TX, USA) MIOL and the Tecnis ZMB00 (Abbott Laboratories, Inc., Abbott Park, IL, USA) MIOL have FDA approval and a large database of detailed clinical results.

Keywords: Presbyopia, near vision, intermediate vision, multifocal IOL, bifocal IOL, trifocal IOL, range of vision, complication, halo, glare.