COMPARATIVE VISUAL OUTCOMES, QUALITY OF VISION, AND SAFETY OF MULTIFOCAL AND EXTENDED DEPTH OF FOCUS INTRAOCULAR LENSES IN AGE-RELATED CATARACT: A SYSTEMATIC REVIEW

M.D. RAKHIMOVA, N.A. ALDASHEVA, L.N. ORAZBEKOV, Zauresh Utelbayeva

2026

Full text Open access: Gold Metadata (CSL-JSON)
DOI 10.53065/kaznmu.2026.78.3.002
Data confidence 70 medium
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Abstract

Abstract Introduction. Premium intraocular lenses (IOLs) enable presbyopia correction during cataract surgery. Multifocal IOLs create discrete foci, while extended depth of focus (EDOF) lenses provide a continuous range through aberration modification. Direct comparison is needed to guide clinical choices regarding effectiveness, safety, and visual phenomena (halos, glare). Aim. To systematically compare visual functions, quality of vision, and safety of multifocal versus EDOF IOLs in age-related cataract. Materials and Methods.A systematic search was conducted in PubMed/MEDLINE and Google Scholar (January 2020 – April 2025). Inclusion criteria: adults with age-related cataract undergoing bilateral phacoemulsification with implantation of a premium IOL (multifocal, trifocal, EDOF, or hybrid), with direct comparison against another premium or monofocal IOL type and reporting quantitative postoperative visual outcomes. Studies without direct comparative data or with unilateral implantation were excluded. Methodological quality was assessed using the Jadad scale (RCTs) and the Newcastle-Ottawa Scale (observational studies). Fourteen primary comparative studies met inclusion criteria. Pooled meta-analysis was applied to extractable comparable outcomes using a random-effects model; remaining outcomes were narratively synthesized. Results. EDOF and hybrid EDOF-multifocal IOLs showed advantages for intermediate visual acuity and broader functional range. Trifocal IOLs remained superior for near vision and spectacle independence. Distance vision was comparable across types. Photic phenomena frequency varied by design, but definitions were inconsistent. Conclusion. Each type of premium IOL possesses a unique efficacy profile. The choice between multifocal and EDOF lenses should be based on an individual analysis of the patient's visual needs: a priority for near vision favors trifocal IOLs, while an emphasis on intermediate vision and visual quality in mesopic conditions favors EDOF IOLs. Key words: cataract, multifocal IOLs, EDOF IOLs, trifocal IOLs, dysphotopsia.