Premium Intraocular Lenses and Their Impact on Visual Field Assessment: A Narrative Review

Premium intraocular lens (IOL) such as enhanced monofocal, extended depth-of-focus (EDOF) and multifocal IOL has become increasing popular due to its ability to treat pseudophakic presbyopia and it also offers a spectacle-free lifestyle. However, the difference in light focality between these types of lenses may affect post operative outcomes, such as the worsening of visual field defects. From the existing literature, seven articles were selected for inclusion in this review to determine the effect of these presbyopia-correcting lenses on visual field assessment. Inclusion criteria included articles involving healthy individuals without ocular pathologies and patients diagnosed with glaucoma, all whom had undergone cataract surgery, and had a comparison of visual field outcomes between different types of intraocular lenses such as multifocal, EDOF, enhanced monofocal, and standard monofocal. A key limitation in the available evidence is that most of these studies involved healthy individuals without ocular comorbidities. Only two studies recruited patients diagnosed with glaucoma implanted with an enhanced monofocal lens or a standard monofocal lens. There have been no studies on glaucoma patients implanted with either EDOF or multifocal lenses. In conclusion, EDOF and enhanced monofocal may be viable options for patients with glaucoma seeking spectacle independence after cataract surgery. Multifocal and trifocal lenses should be avoided in this group of patients because of their refractive and diffractive aberration effects on the visual field.