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

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.