Cochrane Summaries

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A comparison of multifocal and monofocal intraocular lens implants used in cataract surgery

Calladine D, Evans JR, Shah S, Leyland M
Published Online: 
12 September 2012

As people get older, sometimes the lens of the eye becomes cloudy leading to loss of vision. The cloudy lens or cataract can be removed, and a replacement lens put in its place. In the past, the replacement lens had one 'point of focus', either in the distance or close up ('monofocal' lens). This meant that glasses were needed for focusing at other points, for example, for reading. New lenses have been developed that provide two or more points of focus ('multifocal' lenses). These are designed to avoid the need for glasses. We found 16 trials that randomised over 1600 people to either a multifocal or monofocal lens. People who had multifocal lenses were less likely to need spectacles. They had the same visual acuity for seeing in the distance compared to people who had monofocal lenses but had better visual acuity for near vision. The multifocal lenses had drawbacks: people with these lenses were more likely to see halos around lights and had reduced contrast sensitivity (the ability to distinguish an object against a background which is similar to the object itself). Multifocal lens implants reduce spectacle dependence after cataract surgery but at the expense of clarity. Ultimately it will be up to the individual to decide which type of lens they would prefer.