Consider all aspects before using multifocal IOLs, surgeon says

BERLIN — Ophthalmologists may consider using multifocal IOLs, but the technology has drawbacks that should not be underestimated, according to a speaker here.

"The word 'premium' suggests that you are not up to scratch as a surgeon if you don't use them. However, a review of the literature confirms that they reduce contrast sensitivity and induce photic phenomena. I suspect one of the reasons for patient's acceptance of a compromise in their quality of vision is that they are accustomed to poor vision due to cataract or refractive error," Graham Barrett, MD, said at the European Society of Cataract and Refractive Surgeons meeting.

He also said that low levels of defocus such as astigmatism, posterior capsule opacification and macula dysfunction have a greater effect on visual acuity with multifocal IOLs.

Secondary intervention such as LASIK and YAG capsulotomy may be required in as many as 30% of patients and the explantation rate may be as high as 7%, he said.

Dr. Barrett said he prefers pseudophakic monovision, which, in his opinion, has fewer contraindications and better results.