Visual function after bilateral implantation of multifocal versus monofocal IOLs in children below 5 years of age

Background: Since pediatric ophthalmologists still prefer to implant monofocal IOL and experience with multifocal IOL implantation in children is limited. Therefore, the aim of the study was to evaluate visual results after bilateral implantation of multifocal versus monofocal IOLs in children aged 1–5 years with congenital cataract. Methods: Children between 1 and 5 years of age with bilateral cataract who underwent cataract removal implantation of an multifocal IOL – Lentis Mplusx, Oculentis GmbH, Germany (55 children – group A) or monofocal IOL – C-flex Aspheric Monofocal, Rayner Intraocular Lenses Limited, UK (55 children – group B). The distance corrected visual acuity, distance corrected near visual acuity, binocular function using the Worth 4-dot test, stereopsis using the TNO test were evaluated. Results: At the final follow-up visit after 12 months, the mean best corrected distant visual acuity was not significantly different between groups A and B but the best corrected near visual acuity, binocular vision and stereopsis were significantly better in patients from group A as compared to group B. Conclusion: Implantation of a multifocal IOL in children aged 1–5 years with bilateral cataract provides a better level of near vision and considerably improves the development of stereopsis in comparison with children after monofocal IOL implantation.