Beyond monofocal optics, below extended depth of focus IOLs – new standard in cataract surgery with monofocal plus? Review article

Main Article Content

Andrzej Dmitriew
Ewa Goździewska
Jarosław Kocięcki


Recently, due to higher demand for presbyopia correction, we are seeing an increase in the variety of premium intraocular lenses, which are used during cataract surgery. Premium intraocular lenses include multifocal lenses, lenses with extended depth of focus/field, and recently developed enhanced monofocal or monofocal plus lenses. In the article, we discuss the characteristics of monofocal plus lenses and lenses with extended depth of focus/field, the basics of enhanced monovision technique, and general rules of patient’s qualification  for these types of lenses.


Download data is not yet available.

Article Details

How to Cite
Dmitriew A, Goździewska E, Kocięcki J. Beyond monofocal optics, below extended depth of focus IOLs – new standard in cataract surgery with monofocal plus?. Ophthatherapy [Internet]. 2022Dec.31 [cited 2024Jun.19];9(4):273-7. Available from:
Surgery and laser therapy


1. Swartz TS. A guide to the latest presbyopia-correcting IOLs. Optometry Times Journal. 2021; 13(1): 22-8.
2. Muzyka-Woźniak M. Soczewki typu premium – dla kogo są przeznaczone i czy są skuteczne? Okulistyka po Dyplomie. 2020; 8(4): 18-26.
3. Salerno LC, Tiveron MC Jr, Alio JL. Multifocal intraocular lenses: Types, outcomes, complications and how to solve them. Taiwan J Ophthalmol. 2017; 7(4): 179-84.
4. Rocha KM. Extended Depth of Focus IOLs: The Next Chapter in Refractive Technology? J Refract Surg. 2017; 33(3): 146-9.
5. Kohnen T, Suryakumar R. Extended depth-of-focus technology in intraocular lenses. J Cataract Refract Surg. 2020; 46(2): 298-304.
6. Kanclerz P, Toto F, Grzybowski A. Extended Depth-of-Field Intraocular Lenses: An Update. Asia Pac J Ophthalmol (Phila). 2020; 9(3): 194-202.
7. Cochener B, Boutillier G, Lamard M et al. A Comparative Evaluation of a New Generation of Diffractive Trifocal and Extended Depth of Focus Intraocular Lenses. J Refract Surg. 2018; 34(8): 507-14. http://
8. Woodward MA, Randleman J, Stulting R. Dissatisfaction after multifocal intraocular lens implantation. J Cataract Refract Surg. 2009; 35(6): 992-7.
9. Alio JL. Presbyopic lenses: evidence, masquerade news, and fake news. Asia Pac J Ophthalmol (Phila). 2019; 8: 273-4.
10. Rampat R, Gatinel D. Multifocal and extended depth of focus IOLs. Time to change the name of the game? Cataract & Refractive Surgery Today Europe. 2021; 02.
11. Łabuz G, Son HS, Naujokaitis T et al. Laboratory Investigation of Preclinical Visual-Quality Metrics and Halo-Size in Enhanced Monofocal Intraocular Lenses. Ophthalmol Ther. 2021; 10(4): 1093-104.
12. Barsam A, Laginaf M. RayOne EMV: Extended Range of Vision for Patients With or Without Monovision. Supplement to Cataract & Refractive surgery Today Europe. 2021; 04.
13.Goldberg DG, Goldberg MH, Shah R et al. Pseudophakic mini-monovision: high patient satisfaction, reduced spectacle dependence, and low cost. BMC Ophthalmol. 2018; 18(1): 293.
14. Zhang F, Sugar A, Jacobsen G et al. Visual function and spectacle independence after cataract surgery: bilateral diffractive multifocal intraocular lenses versus monovision pseudophakia. J Cataract Refract Surg. 2011; 37(5): 853-8.
15. Labiris G, Toli A, Perente A et al. A systematic review of pseudophakic monovision for presbyopia correction. Int J Ophthalmol. 2017; 10(6): 992-1000.
16. Zettl S, Reiß S, Terwee T et al. Effect of pseudophacic mini-monovision as an option for independence of spectacles in everyday life. Klin Monbl Augenheilkd. 2014; 231(12): 1196-202.
17. Ito M, Shimizu K, Niida T et al. Binocular function in patients with pseudophakic monovision. J Cataract Refract Surg. 2014; 40(8): 1349-54. http://
18. Lubiński W, Cholewa M, Podboraczyńska-Jodko K. Conventional pseudophakic monovision-visual function, patient satisfaction and complications. Klin Oczna. 2013; 115(3): 189-93.
19. Nowik, K, Izdebska J, Nowik K et al. Wewnątrzgałkowe soczewki o wydłużonej ogniskowej jako metoda korekcji starczowzroczności. Extended Depth of Focus Intraocular Lenses as a Method of Presbyopia Correction. Okulistyka. 2020; 2: 16-8.
20. Greenstein S, Pineda R. The Quest for Spectacle Independence: A Comparison of Multifocal Intraocular Lens Implants and Pseudophakic Monovision for Patients with Presbyopia. Semin Ophthalmol. 2017; 32(1): 111-5.
21. Rudalevicius P, Lekaviciene R, Auffarth GU et al. Relations between patient personality and patients’ dissatisfaction after multifocal intraocular lens implantation: clinical study based on the five factor inventory personality evaluation. Eye (Lond). 2020; 34(4): 717-24.
22. Spyra M, Cisek E, Cisek A et al. Współczesne możliwości korekcji prezbiopii pooperacyjnej metodami implantacji soczewek wewnątrzgałkowych u pacjentów z zaćmą. Ophthatherapy. 2016; 4(12): 270-8.
23. Ferreira TB, Pinheiro J, Zabala L et al. Comparative analysis of clinical outcomes of a monofocal and an extended-range-of-vision intraocular lens in eyes with previous myopic laser in situ keratomileusis. J Cataract Refract Surg. 2018; 44(2): 149-55.
24. Ouchi M, Shiba T. Diffractive multifocal intraocular lens implantation in eyes with a small-diameter pupil. Sci Rep. 2018; 8(1): 11686.