Add-on #multifocal lenses for patients who have had monofocal lenses at the time of #cataract surgery

Patients who have had previous cataract surgery with monofocal lens implants may want independence from glasses for near and distance vision. A recent study shows that an add-on multifocal lens implant can restore near vision in a similar manner to a multifocal lens implanted in the first instance at the time of cataract surgery in these patients. This allows patients to 'upgrade' the function of their lenses at a later date if they wish to do so. Importantly the procedure is reversible in the event that the person does not adapt to vision with a multifocal lens.

J Cataract Refract Surg. 2015 Oct;41(10):2107-14. doi: 10.1016/j.jcrs.2015.10.055.

Visual function and reading speed after bilateral implantation of 2 types of diffractive multifocal intraocular lenses: Add-on versus capsular bag design.

Liekfeld A1Ehmer A2Schröter U2.

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To compare the functional outcomes of primary implantation of a monofocal intraocular lens (IOL) in the capsular bag and an add-on multifocal IOL in the sulcus with the functional results of a conventional multifocal posterior chamber IOL and to evaluate the multifocal add-on IOL as an effective alternative to a conventional multifocal IOL.


Ernst von Bergmann Eye Clinic, Potsdam, Germany.


Prospective nonrandomized case series.


Cataract surgery patients were assigned to have bilateral implantation of a monofocal IOL (Aspira-aAY) in the capsular bag followed by a multifocal add-on IOL (Diff-sPB) in the sulcus (Group A) or with a conventional multifocal IOL (Diffractiva-s) in the capsular bag (Group B). The main study outcomes were assessed at the last follow-up visit (6 months postoperatively) and included refraction, intraocular pressure, visual acuity, reading speed, contrast sensitivity, defocus curve, and patient satisfaction.


The study comprised 26 patients (52 eyes) Cataract surgery was uneventful in all cases. No severe complications were observed 6 months postoperatively. Visual performance with a multifocal diffractive add-on IOL was equivalent to that achieved with a conventional multifocal diffractive posterior chamber IOL. Similarly, there were no significant differences in patient satisfaction and reading speed for any type of letter size between groups (P > .05).


Implanting a multifocal add-on IOL in the sulcus in addition to a monofocal IOL in the capsular bag produced outcomes similar to those of single implantation of a standard multifocal IOL in the capsular bag.

Posted on March 28, 2016 .