Multifocal intraocular lens implantation in children

Article

In children, implantation of a multifocal IOL remains a topic of debate. With lacking evidence on post surgery outcomes and no head-to-head comparison of multifocal IOLs in children, this issue remains to be clarified. Therefore, the authors of this article were prompted to perform research in this area to address a number of concerns among paediatric ophthalmologists.

Why try multifocal at all?

Studies such as the one conducted by Dr Phillip C. Jacobi et al., 2 have shown promising results with the use of multifocal IOLs in children. Children with unilateral cataracts had a satisfactory outcome with multifocal IOLs as per a study by Dr José Cristóbal.3 Multifocal IOLs come with an advantage of promoting binocularity and improved stereopsis. In adult patients, multifocal IOLs considerably reduce the dependability on glasses. There is no evidence whether multifocal IOLs offer similar benefits in children.

Children with bilateral cataracts propose a unique clinical situation because they do not have normal eyes with youthful accommodation. In our study, we selected children older than 5 years of age so that by this time, the growth of the eye has been largely completed.1 Children with bilateral congenital/ developmental cataracts were included in the study.

We compared the performance of two types of multifocal IOLs, AcrySof IQ ReSTOR SN6AD1 IOL (Alcon Laboratories, Fort Worth, Texas, USA) with +3 D add for near and Preziol with +4 D add (Care group, Baroda, India). AcrySof IQ ReSTOR has apodized diffractive optics and Preziol is an aspheric refractive IOL.

Monofocal IOLs used in the study included Sensar OptiEdge (AMO, Santa Ana, California, USA) and Alcon MA60AC or SA60AT IOLs. The children were tested for near and distance visual acuity, fusional status, contrast sensitivity and stereopsis.

Results in brief

However, there was spectacle independence in more than 70% cases with multifocal IOLs over one year follow-up period. It was encouraging to note that multifocal IOLs did not decrease the contrast sensitivity and stereopsis versus the monofocal IOLs.

Apodized diffractive IOLs performed better than refractive IOLs. This means that with development of newer designs of multifocal IOLs, it is certainly possible to achieve good vision without compromising on its quality.

Newsletter

Join ophthalmologists across Europe—sign up for exclusive updates and innovations in surgical techniques and clinical care.

Recent Videos
Rayaz Malik, MBChB, PhD, a professor of medicine at Weill Cornell Medicine - Qatar, spoke with Ophthalmology Times Europe about his presentation. It's titled "An eye on neurodegenerative diseases: Challenging the dogma" at the International SPECTRALIS Sympsoium. In conversation with Hattie Hayes, Ophthalmology Times Europe
Anat Loewenstein, MD, describes her presentation on remote imaging for age-related macular degeneration and geographic atrophy at the International SPECTRALIS Symposium, in conversation with Hattie Hayes of Ophthalmology Times Europe
Tyson Brunstetter, OD, PhD, a US Navy Aerospace Optometrist at the NASA Johnson Space Center in Houston, Texas, shares key takeaways from his keynote at the International SPECTRALIS Symposium (ISS)
Rayaz Malik, MBChB, PhD, shares his presentation, titled An eye on neurodegenerative diseases: Challenging the dogma, at this year's International SPECTRALIS Symposium
At the Retina World Congress, Siegfried Priglinger, MD, speaks about ensuring the best outcomes for preschool-aged patients
At the 2025 ASCRS meeting, Robert Ang, MD said small aperture IOLs can benefit all patients, especially those with complex corneas or who have undergone previous corneal refractive surgery
Viha Vig, MBChB graduate student at the University of Auckland, New Zealand, discusses her poster presentation on the relationship between mitochondiral disease, Alzheimer disease, and other types of dementia.
Alfredo Sadun, MD, PhD, chief of Ophthalmology at the Doheny Eye Institute, University of California Los Angeles, shared exciting new research with the Eye Care Network during the Association for Research in Vision and Ophthalmology (ARVO) meeting on the subject of Leber hereditary optic neuropathy (LHON).
At this year's Association for Research in Vision and Ophthalmology (ARVO) meeting in Salt Lake City, Utah, Nitish Mehta, MD, shared highlights from his research documenting real-world results of aflibercept 8 mg for patients with diabetic macular oedema.
ARVO 2025: Anat Loewenstein, MD, shares data from herself and her colleagues on meeting needs of patients with diabetic retinopathy
© 2025 MJH Life Sciences

All rights reserved.