An Update on Intraocular Lens Technology for Presbyopia Correction and Visual Outcomes.

BACKGROUND/

OBJECTIVES

Choosing the most appropriate intraocular lens (IOL) for presbyopia management may be challenging given the expanding selection of available designs. This review provides an updated overview of current monofocal plus, extended depth of focus (EDoF), and trifocal IOLs, summarizing their optical properties and laboratory and clinical findings, including visual acuity outcomes and side effects.

METHODS

A literature search was conducted using PubMed to identify studies on monofocal plus, EDoF, and trifocal IOLs, with emphasis on optical characteristics, visual acuity outcomes, and reported photic phenomena.

RESULTS

Monofocal plus IOLs demonstrate an improvement in depth of field compared to monofocal lenses, as evidenced by significant broadening of the defocus curve. Both refractive and diffractive EDoF IOLs show improved intermediate visual acuity, with diffractive models offering greater depth of field but a higher risk of dysphotopsia. Trifocal IOLs offer the best visual acuity at all three foci: near, intermediate, and distance. Patients' needs may be customized using sulcus- or capsulotomy-fixated IOLs, mix-and-match strategies, and binocular IOL systems.

CONCLUSIONS

Based on this literature review, clinical and optical bench studies to date support optimized IOL selection based on individual patient needs for presbyopia management. However, consideration of understudied or newly released IOL models is limited as future research is needed. Additionally, further prospective, randomized, controlled, and masked studies with large sample sizes on all IOL models may further support patient decision-making by contributing to a more comprehensive literature.