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Evidence summaries

Multifocal Versus Monofocal Intraocular Lenses after Cataract Extraction

The use of multifocal intraocular lenses appears to improve near vision without any adverse effect on distance acuity, and to increase spectacle independence, at the cost of a reduction in contrast sensitivity and the experience of haloes compared with monofocal intraocular lenses. Level of evidence: "B"

A Cochrane review [Abstract] 1 included 20 studies with a total of 2230 subjects. Most studies compared multifocal and monofocal lenses but there was considerable variety in the make and model of lenses implanted. Similar distance acuity was achieved with both types of lenses. People with multifocal lenses had better near vision and were less spectacle dependent (table T1. Adverse subjective visual phenomena, particularly haloes, or rings around lights, were more prevalent and more troublesome in participants with the multifocal lenses and there was evidence of reduced contrast sensitivity with the multifocal lenses.

Multifocal compared to monofocal intraocular lenses after cataract extraction

Outcome (Follow-up: 6 weeks to 18 months)Relative effect(95% CI)Assumed risk - Control -Monofocal intraocular lensCorresponding risk - Intervention - Multifocal intraocular lensNo of participants(studies) Quality of evidence
Unaided distance visual acuity worse than 6/6RR 0.96(0.89 to 1.03)800 / 1000768 / 1000(712 to 824)682(8) Moderate
Unaided near visual acuity worse than J3/J4RR 0.20(0.07 to 0.58)570 / 1000114 / 1000(40 to 330)782(8) Low
Spectacle dependenceRR 0.63(0.55 to 0.73)880 / 1000554 / 1000 (484 to 642)1000(10) Low
Participant-reported outcomes: glareRR 1.41(1.03 to 1.93)180 / 1000254 / 1000(185 to 347)544(7) Low
Participant-reported outcomes: haloesRR 3.58(1.99 to 6.46)80 / 1000286 / 1000 (159 to 517)662(7) Moderate

    References

    • Calladine D, Evans JR, Shah S et al. Multifocal versus monofocal intraocular lenses after cataract extraction. Cochrane Database Syst Rev 2012;(9):CD003169 [Assessed as up-to-date: 13 June 2016]. [PubMed].

Primary/Secondary Keywords