title: Efficacy and safety of multifocal intraocular lenses following cataract and refractive lens exchange: Metaanalysis of peer-reviewed publications.
abstract: We performed a metaanaysis of peer-reviewed studies involving implantation of a multifocal intraocular lens (IOL) in presbyopic patients with cataract or having refractive lens exchange (RLE). Previous reviews have considered the use of multifocal IOLs after cataract surgery but not after RLE, whereas greater insight might be gained from examining the full range of studies. Selected studies were examined to collate outcomes with monocular and binocular uncorrected distance, intermediate, and near visual acuity; spectacle independence; contrast sensitivity; visual symptoms; adverse events; and patient satisfaction. In 8797 eyes, the mean postoperative monocular uncorrected distance visual acuity (UDVA) was 0.05 logMAR ± 0.006 (SD) (Snellen equivalent 20/20(-3)). In 6334 patients, the mean binocular UDVA was 0.04 ± 0.00 logMAR (Snellen equivalent 20/20(-2)), with a mean spectacle independence of 80.1%. Monocular mean UDVA did not differ significantly between those who had a cataract procedure and those who had an RLE procedure. Neural adaptation to multifocality may vary among patients.
  
  
  BACKGROUND
  Dr. Alió is a clinical research investigator for Hanita Lenses, Carl Zeiss Meditec AG, Topcon Medical Systems, Inc., Oculentis GmbH, and Akkolens International BV. Dr. Dell is a consultant to Bausch & Lomb and Abbott Medical Optics, Inc. Dr. Slade is a consultant to Alcon Surgical, Inc., Carl Zeiss Meditec AG, and Bausch & Lomb. None of the authors has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: From a private practice (Rosen), Manchester, United Kingdom; the Division of Ophthalmology (Alió), Vissum Corporation, Universidad Miguel Hernandez, Alicante, Spain; the University Eye Hospital (Dick), Bochum, Germany; Dell Laser Consultants (Dell), Austin and Slade & Baker Vision (Slade), Houston, Texas, USA. Electronic address: erosen9850@aol.com.
authors.forename: Emanuel
authors.initials: E
authors.lastname: Rosen
authors.affiliation: From a private practice (Rosen), Manchester, United Kingdom; the Division of Ophthalmology (Alió), Vissum Corporation, Universidad Miguel Hernandez, Alicante, Spain; the University Eye Hospital (Dick), Bochum, Germany; Dell Laser Consultants (Dell), Austin and Slade & Baker Vision (Slade), Houston, Texas, USA.
authors.forename: Jorge L
authors.initials: JL
authors.lastname: Alió
authors.affiliation: From a private practice (Rosen), Manchester, United Kingdom; the Division of Ophthalmology (Alió), Vissum Corporation, Universidad Miguel Hernandez, Alicante, Spain; the University Eye Hospital (Dick), Bochum, Germany; Dell Laser Consultants (Dell), Austin and Slade & Baker Vision (Slade), Houston, Texas, USA.
authors.forename: H Burkhard
authors.initials: HB
authors.lastname: Dick
authors.affiliation: From a private practice (Rosen), Manchester, United Kingdom; the Division of Ophthalmology (Alió), Vissum Corporation, Universidad Miguel Hernandez, Alicante, Spain; the University Eye Hospital (Dick), Bochum, Germany; Dell Laser Consultants (Dell), Austin and Slade & Baker Vision (Slade), Houston, Texas, USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Dell
authors.affiliation: From a private practice (Rosen), Manchester, United Kingdom; the Division of Ophthalmology (Alió), Vissum Corporation, Universidad Miguel Hernandez, Alicante, Spain; the University Eye Hospital (Dick), Bochum, Germany; Dell Laser Consultants (Dell), Austin and Slade & Baker Vision (Slade), Houston, Texas, USA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Slade
mesh_terms: D002386:Cataract / Q000150:complications; D006801:Humans; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D018918:Phacoemulsification; D011305:Presbyopia / Q000150:complications / Q000601:surgery; D011474:Prosthesis Design; D019591:Pseudophakia / Q000503:physiopathology*; D012029:Refraction, Ocular / Q000502:physiology; D012086:Reoperation; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology