title: Refractive versus diffractive multifocal intraocular lenses in cataract surgery: a meta-analysis of randomized controlled trials.
abstract: METHODS
  Data sources, including PubMed, Medline, Embase, and the Cochrane Controlled Trials Register, were used to identify potentially relevant randomized controlled trials. Eight qualified studies incorporating 1,242 eyes of 621 patients were analyzed using Rev- Manager version 5.2 software (The Cochrane Collaboration, Oxford, England). The primary measures included uncorrected distance, intermediate, and near visual acuity. Reading ability, spectacle independence, and occurrence of photic phenomena were also addressed.
  
  
  RESULTS
  The refractive MIOL group exhibited better uncorrected distance visual acuity than the diffractive MIOL group (weighted mean difference [WMD] = -0.04, 95% confidence interval [CI]: -0.06 to -0.02, P < .01). However, the diffractive MIOL group performed better than the refractive MIOL group in uncorrected near visual acuity, reading acuity, reading speed, smallest print size, spectacle independence, halo, and glare rate (WMD = 0.13, 95% CI: 0.10 to 0.17, P < .01; WMD = 0.14, 95% CI: 0.08 to 0.19, P < .01; WMD = -24.14, 95% CI: -43.56 to -4.72, P = .01; WMD = 0.56, 95% CI: 0.43 to 0.69, P < .01; WMD = 0.56, 95% CI: 0.45 to 0.70, P < .01; WMD = 1.50, 95% CI: 1.16 to 1.93, P = .002; WMD = 1.39, 95% CI: 1.10 to 1.75, P = .006, respectively). There was no significant difference between the two groups in uncorrected intermediate visual acuity (WMD = -0.04, 95% CI: -0.09 to 0.00, P = .05).
  
  
  CONCLUSIONS
  Refractive MIOLs can provide better distance vision, whereas diffractive MIOLs provide better near vision, reading ability, and equivalent intermediate vision, reduce unwanted photic phenomena, and allow greater spectacle independence.
authors.forename: Xian
authors.initials: X
authors.lastname: Xu
authors.forename: Ming-Ming
authors.initials: MM
authors.lastname: Zhu
authors.forename: Hai-Dong
authors.initials: HD
authors.lastname: Zou
mesh_terms: D016208:Databases, Factual; D019466:Glare; D006801:Humans; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D018918:Phacoemulsification; D011474:Prosthesis Design; D016032:Randomized Controlled Trials as Topic; D011932:Reading; D014792:Visual Acuity / Q000502:physiology*