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Related Experiment Video

Updated: Jul 29, 2025

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Recommendation for Presbyopia-Correcting Intraocular Lenses: A Delphi Consensus Statement by the ESASO Study Group.

Vito Romano1, David Madrid-Costa2, Jose F Alfonso3

  • 1From Eye Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy (V.R.).

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|May 26, 2023
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Summary

Expert consensus was reached on preoperative, intraoperative, and postoperative considerations for presbyopia-correcting intraocular lenses (IOLs). However, IOL selection criteria for these advanced lenses lacked agreement among specialists.

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Area of Science:

  • Ophthalmology
  • Refractive Surgery
  • Biomedical Engineering

Background:

  • Presbyopia-correcting intraocular lenses (IOLs) offer solutions for age-related vision loss.
  • General ophthalmologists require guidance on optimal patient selection and management for these advanced IOLs.
  • Establishing expert consensus is crucial for standardizing care and improving patient outcomes.

Purpose of the Study:

  • To achieve expert consensus on key issues surrounding presbyopia-correcting IOLs.
  • To provide practical guidance for general ophthalmologists managing patients undergoing IOL surgery.
  • To address preoperative, intraoperative, and postoperative considerations for multifocal and extended depth of focus IOLs.

Main Methods:

  • A modified Delphi method was employed to gather expert opinions.
  • A steering committee developed 105 items across four key areas: preoperative, IOL selection, intraoperative, and postoperative considerations.
  • Consensus was defined as agreement by at least 70% of participating experts.

Main Results:

  • Consensus was achieved on 70.6% of preoperative considerations and 71.4% of intraoperative considerations.
  • The highest consensus (76.9%) was observed in postoperative considerations.
  • Significant disagreement persisted regarding specific IOL selection criteria, with only patient habits showing consensus.

Conclusions:

  • Key recommendations were established for diffractive multifocal IOLs regarding visual acuity, keratometry, pupil size, and corneal aberrations.
  • Monofocal or non-diffractive IOLs are recommended for patients with ocular comorbidities.
  • Further research and discussion are needed to establish clear guidelines for IOL selection in presbyopia correction.