Monovision versus multifocality for presbyopia during primary phacoemulsification: systematic review and network...

Area of Science:

• Ophthalmology
• Biomedical Engineering
• Clinical Medicine

Background:

• Presbyopia, an age-related condition, commonly affects post-cataract surgery patients.
• Monovision and bilateral multifocal intraocular lenses (bMFIOL) are surgical options for presbyopia correction.
• Evaluating the comparative efficacy and patient satisfaction of these methods is crucial.

Purpose of the Study:

• To compare the efficacy of monovision versus bMFIOL implantation for presbyopia treatment.
• To assess user satisfaction and limitations associated with each approach.
• To provide evidence for optimal surgical correction of presbyopia.

Main Methods:

• Systematic review and network meta-analysis (NMA) of 32 studies (3082 patients).
• Searched Medline, Embase, and Cochrane library up to July 15, 2022.
• Included studies with direct or indirect comparisons of monovision and bMFIOL in bilateral cataract surgery.

Main Results:

• bMFIOLs were more likely to provide complete spectacle independence compared to monovision (RR = 2.06, p = 0.002).
• Monovision resulted in significantly less glare than bMFIOL (RR = 0.343, p = 0.001).
• No significant difference was found in binocular distance or near visual acuity between the two methods.

Conclusions:

• bMFIOL implantation offers superior spectacle independence for presbyopia compared to monovision.
• Monovision may be preferred when minimizing glare is a priority.
• Further research with standardized reporting is needed due to data heterogeneity.