A recent study published in JAMA Ophthalmology suggests that the most favorable approach to correct presbyopia is the bilateral implantation of trifocal intraocular lenses (IOLs).

The study utilized Bayesian network meta-analysis (NMA) to compare various types of multifocal and monofocal intraocular lenses (IOLs) commonly used in clinical practice. The objective was to assess the outcomes of presbyopia-correcting IOLs that are frequently recommended in clinical settings, employing a Bayesian NMA methodology based on a systematic review.

The study focused on randomized clinical trials that evaluated multifocal IOLs in patients who had undergone bilateral cataract extraction. Nonrandomized studies, studies involving patients with unilateral or contralateral cataract extractions, duplicated studies, conference abstracts, and non-peer-reviewed articles were excluded from the analysis.

Key findings of the study include:

– The NMA encompassed 27 studies, involving 2605 patients.
– Trifocal IOLs and traditional bifocal diffractive IOLs provided superior uncorrected near visual acuity compared to monofocal IOLs.
– Extended depth-of-focus IOLs demonstrated better uncorrected intermediate visual acuity compared to monofocal IOLs.
– However, in pairwise comparisons, there were no significant differences between extended depth-of-focus IOLs and trifocal diffractive IOLs.
– Multifocal IOLs, in general, were comparable to monofocal IOLs in terms of uncorrected distant visual acuity. No statistically significant distinctions were observed between multifocal and monofocal IOLs concerning contrast sensitivity, glare, or halos.

In conclusion, for patients considering multifocal IOLs as a solution for presbyopia, the study suggests that bilateral implantation of trifocal IOLs might be the optimal choice. This approach allows patients to address presbyopia effectively without compromising their distant visual acuity.