Monofocal plus – future or present? Review article

Main Article Content

Adam Kabiesz
Joanna Grzbiela
Damian Skorupka
Patryk Zemła
Alfred Niewiem


The implantation of extended deep-of-focus intraocular lenses during cataract surgery allows patients to achieve spectacles independence. Correct calculation of the power of the lenses and the use of monovision significantly improves the level of satisfaction after the procedure. The choice of the target postoperative refraction of the dominant eye within the limits of emmetropia and the non-dominant eye with slight myopia within the range of -1.0 D can provide satisfactory visual acuity for a long distance, intermediate and near vision, without the need for glasses. Some authors classify some types of monofocal plus on an equal footing with lenses with an extended depth of focus. They are the latest solution in cataract surgery and are characterized by a low tendency to cause side effects typical of multifocal lenses.


Download data is not yet available.

Article Details

How to Cite
Kabiesz A, Grzbiela J, Skorupka D, Zemła P, Niewiem A. Monofocal plus – future or present?. Ophthatherapy [Internet]. 2024Mar.31 [cited 2024Jul.18];11(1):92-8. Available from:
Surgery and laser therapy


1. Hashemi H, Hatef E, Fotouhi A et al. The prevalence of lens opacities in Tehran: the Tehran Eye Study. Ophthalmic Epidemiol. 2009; 16(3): 187-92.
2. Alio JL, Grzybowski A, El Aswad A et al. Refractive lens exchange. Surv Ophthalmol. 2014; 59(6): 579-98.
3. Costa VP, Leung CKS, Kook MS, Lin SC; Global Glaucoma Academy. Clear lens extraction in eyes with primary angle closure and primary angle-closure glaucoma. Surv Ophthalmol. 2020; 65(6): 662-74.
4. Day AC, Gore DM, Bunce C et al. Laser-assisted cataract surgery versus standard ultrasound phacoemulsification cataract surgery. Cochrane Database Syst Rev. 2016; 7(7): CD010735.
5. Sahay P, Goel S, Maharana PK et al. Sequelae of neglected hypermature senile cataract. Indian J Ophthalmol. 2019; 67(10): 1707-8.
6. Davis G. The Evolution of Cataract Surgery. Mo Med. 2016; 113(1): 58-62.
7. Maurino V, Allan BD, Rubin GS et al.; Moorfields IOL Study Group. Quality of vision after bilateral multifocal intraocular lens implantation: a randomized trial – T LISA 809M versus AcrySof ReSTOR SN6AD1. Ophthalmology. 2015; 122(4): 700-10.
8. Moshirfar M, Milner D, Patel BC. Cataract Surgery. 18. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023.
9. Kanclerz P, Toto F, Grzybowski A, Alio JL. Extended Depth-of-Field Intraocular Lenses: An Update. Asia Pac J Ophthalmol (Phila). 2020; 9(3): 194-202.
10. 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.
11. Rampat R, Gatinel D. Multifocal and Extended Depth-of-Focus Intraocular Lenses in 2020. Ophthalmology. 2021; 128(11): e164-85.
12. Böhm M, Petermann K, Hemkeppler E et al. Defocus curves of 4 presbyopia-correcting IOL designs: Diffractive panfocal, diffractive trifocal, segmental refractive, and extended-depth-of-focus. J Cataract Refract Surg. 2019; 45(11): 1625-36.
13. Tandogan T, Son HS, Choi CY et al. Laboratory Evaluation of the Influence of Decentration and Pupil Size on the Optical Performance of a Monofocal, Bifocal, and Trifocal Intraocular Lens. J Refract Surg. 2017; 33(12): 808-12.
14. Tran DB, Owyang A, Hwang J et al. Visual Acuity, Quality of Vision, and Patient-Reported Outcomes After Bilateral Implantation with a Trifocal or Extended Depth of Focus Intraocular Lens. Clin Ophthalmol. 2021; 15: 403-12.
15. Kohnen T, Suryakumar R. Extended depth-of-focus technology in intraocular lenses. J Cataract Refract Surg. 2020; 46(2): 298-304.
16. Alió JL. Extended depth of field lenses: Types, lights and shadows. Arch Soc Esp Oftalmol (Engl Ed). 2021; 96(10): 507-8.
17. Schmid R, Borkenstein AF. Analysis of higher order aberrations in recently developed wavefront-shaped IOLs. Graefes Arch Clin Exp Ophthalmol. 2022; 260(2): 609-20.
18. Misiuk-Hojło M, Dołowiec-Kwapisz A. Patient with cataract – observations after 2 years of the pandemic and future prospects. OphthaTherapy. 2022; 9(2): 134-41.
19. RayOne EMV: First Clinical Results. Online.
20. Barsam A, Laginaf M. RayOne EMV: Extended Range of Vision for Patients With or Without Monovision. Cataract & Refractive Surgery Today Europe (Supplement). 2021; April: 10-2.
21. Ferreira T. Comparison of Visual Outcomes Of A Monofocal, Two Enhanced Monofocal And Two Extended Depht-Of-Focus Intraocular Lenses, ESCRS 2022 Milan.
22. Ribeiro R. Enhanced Monofocal’s vs. EDOF. ESCRS 2021 Amsterdam.
23. RayOne EMV and TECNIS Eyhance: A Comparative Clinical Defocus Curve. Online.