Comparison of the Clinical Performance of Refractive Rotationally Asymmetric Multifocal IOLs with Other Types of IOLs: A Meta-Analysis

Objective. To compare the clinical performance of refractive rotationally asymmetric multifocal intraocular lens (IOLs) with spherical monofocal, accommodating, and bifocal IOLs. Methods. A comprehensive literature search of PubMed, EMBASE, Cochrane Controlled Trials Register, and Web of Science up to February 2017 was performed to identify randomized controlled trials (RCT) and comparative cohort studies. Main outcomes were uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), higher-order aberrations (HOAs), MTF, Strehl ratio, and residual sphere and cylinder. Results. Mplus provided significantly worse UDVA than spherical monofocal IOLs (WMD: 0.13, P=0.008), but significantly better UIVA than high-add bifocal IOLs (WMD: −0.19, P