Clinical developments in Multifocal Intraocular Lens Surgery: The ease of being specs-free

In multifocal IOL implantation the aim is to achieve a high level of spectacle independence for all vision distances. Many types of mIOLs have been invented and implemented. Data on the performance of these different types of mIOLs comes from the medical devices industry at the time of launch, and from clinical studies like ours, that are implemented independently of the industries, after a while. This thesis describes different reasons why patients seek multifocal intraocular lenses and refractive surgery, and shows the history and refractive differences of different new generation mIOLs. In this thesis we aim to investigate aspects related to the clinical advantages and disadvantages of different mIOL types and whether postoperative treatment of posterior capsule opacification (PCO) causes clinically significant changes in refraction. Also we have investigated the reliability of postoperative refraction in radially asymmetric multifocal IOLs, and the relation between postoperative satisfaction, refraction and ease of treatment of residual refractive errors. In conclusion we can say that clinical studies such as the above allow for increasingly more complete and concise "mapping" of results with different types of IOLs. These data give us tools for more accurate measurement and treatment of future patients. Concerning our findings on the Nd:YAG capsulotomy, we believe a change in the treatment paradigm can result in prevention of excessive treatment. Since presently Nd:YAG capsulotomy is scheduled for all patients who need treatment of a residual refractive error