Background: Juvenile cataract, occurring within the first decade of life, poses unique challenges for visual development and long-term visual outcomes. Selection of an intraocular lens (IOL) during pediatric cataract surgery is critical for optimizing visual function, reducing dependence on spectacles, and improving quality of life.
Objective: To systematically review and compare the visual outcomes, complications, patient satisfaction, and quality of life associated with multifocal versus monofocal IOL implantation in patients with juvenile cataract.
Methods: A systematic literature search was conducted in PubMed, ScienceDirect, and Google Scholar to identify studies published in the last 15 years. Inclusion criteria comprised studies reporting juvenile cataract surgery with implantation of either multifocal or monofocal IOLs and providing postoperative outcomes. Data extracted included study design, sample size, IOL type, visual acuity, spectacle dependence, complications, quality of life, and follow-up duration. Methodological quality was assessed according to the Oxford Centre for Evidence-Based Medicine (OCEBM) 2011 Levels of Evidence.
Results: Eight studies met the inclusion criteria, encompassing patients aged 1–19 years. Both multifocal and monofocal IOLs significantly improved best-corrected visual acuity (BCVA), with no statistically significant difference between the two groups. Multifocal IOLs offered better near visual acuity (NVA) and reduced dependence on spectacles, enhancing patient-reported quality of life. Complications, including posterior capsule opacification (PCO), glare, and halos, were reported but did not differ significantly between groups. Younger patients demonstrated greater adaptability and visual gains with multifocal IOLs. Surgical technique consistency and accurate IOL power calculation were essential for optimal outcomes.
Conclusion: Multifocal IOLs provide comparable distance vision, superior near vision, and greater independence from spectacles compared to monofocal IOLs in juvenile cataract patients, without increasing significant complications. Individualized IOL selection based on age, visual needs, and patient preferences is recommended. Further large-scale, long-term studies are needed to confirm these findings and guide optimal pediatric IOL selection.
Keywords: Juvenile cataract, pediatric cataract, intraocular lens, multifocal IOL, monofocal IOL, visual acuity.
How to cite this article: Framita J, Ismail MA, Rahmah MN, Muhiddin HS, Syamsu N, Hendarto J. Multifocal versus monofocal intraocular lenses in juvenile cataract: a systematic review of visual outcomes, complications, and quality of life. Int J Drug Deliv Technol. 2026;16(3s): 1032-1040; DOI: 10.25258/ijddt.16.3s.124
Source of support: None.
Conflict of interest: None