Bilateral implantation of trifocal IOLs optimal option for correcting presbyopia: JAMA

A Bayesian network meta-analysis (NMA) can help compare the various types of multifocal and monofocal intraocular lenses (IOLs) used in clinical practice.

A study was done to compare outcomes of presbyopia-correcting IOLs frequently recommended in clinical practice through a bayesian NMA based on a systematic review.

Based on the research question, randomized clinical trials assessing multifocal IOLs in patients who underwent bilateral cataract extraction were searched. Nonrandomized studies, studies in patients with unilateral or contralateral cataract extractions, duplicated studies, conference abstracts, and nonpeer-reviewed articles were excluded.

Results:

• This NMA included 27 studies comprising 2605 patients.
• For uncorrected near visual acuity, trifocal IOLs and old bifocal diffractive IOLs afforded better visual acuity than monofocal IOLs.
• Regarding uncorrected intermediate visual acuity, extended depth-of-focus IOLs provided better visual acuity than monofocal IOLs.
• However, there were no differences between extended depth-of-focus and trifocal diffractive IOLs in pairwise comparisons.
• For uncorrected distant visual acuity, all multifocal IOLs were comparable with monofocal IOLs. There were no statistical differences between multifocal and monofocal IOLs regarding contrast sensitivity, glare, or halos.

Thus, for patients considering a multifocal IOL due to presbyopia, bilateral implantation of a trifocal IOL might be an optimal option for patients without compromising distant visual acuity.

Reference:

Cho J, Won YK, Park J, et al. Visual Outcomes and Optical Quality of Accommodative, Multifocal, Extended Depth-of-Focus, and Monofocal Intraocular Lenses in Presbyopia-Correcting Cataract Surgery: A Systematic Review and Bayesian Network Meta-analysis. JAMA Ophthalmol. Published online September 22, 2022. doi:10.1001/jamaophthalmol.2022.3667

Keywords:

Bilateral, implantation, trifocal, IOLs, optimal, option, correcting, presbyopia, JAMA Ophthalmology, Cho J, Won YK, Park J, Visual Outcomes, Optical Quality, Accommodative, Multifocal, Extended Depth-of-Focus, and Monofocal Intraocular Lenses