Multifocal Intraocular Lenses: Postimplantation Residual Refractive Error

The meteoric technological advances and rapid shifts in the modes of practice have made cataract surgery a major form of refractive surgery. Modern microsurgical techniques, creative IOL technologies, sophisticated methods for biometry, and advanced methods of intraocular lens power calculation allow most cataract patients to regain high-quality vision. With the introduction of multifocal intraocular lenses (MIOLs), many patients request and expect total spectacle independence for all visual tasks. Overall, patient satisfaction scores after implantation of MIOLs are high. Satisfaction scores are closely linked to postop uncorrected distance, near and intermediate, visual acuity. There are various reasons that can lead to residual refractive error after the either clear lens exchange or cataract surgery (e.g. incorrect biometry methods, incorrect estimation of effective lens position and axial length measurement, surgically induced astigmatism, tilting or displacement of IOL). Strategies for correcting any residual refractive error include spectacle correction and contact lenses, corneal incisional procedures or enhancements with excimer laser (LASIK, PRK), conductive keratoplasty and lens based repeat surgery (IOL exchange, piggyback lenses).