International consensuses and guidelines on multifocal intraocular lenses (IOLs) by the Academy of Asia-Pacific Professors of Ophthalmology (AAPPO)

Intraocular Lenses (IOLs) have revolutionized cataract surgery, evolving from simple monofocal designs to advanced multifocal technologies that aim to reduce dependence on glasses after surgery. However, multifocal IOLs remain one of the most debated topics in ophthalmology, with passionate advocates and critics. This controversy stems from the balance between their potential benefits and limitations. The Asia-Pacific Academy of Professors of Ophthalmology (AAPPO) formed an international panel of 25 experts from 14 countries/territories who prepared and voted on consensus statements in twelve key areas: (1) the concept of multifocality; (2) refractive vs diffractive designs; (3) blur and haloes; (4) dysphotopsia; (5) understanding diffractive IOL designs; (6) neuroadaptation; (7) factors that may affect the success of multifocal IOLs; (8) alternatives to multifocal IOLs; (9) extended depth of focus IOLs; (10) other considerations; (11) newer IOL designs; (12) future considerations. Among the 47 consensus statements, 46 (97.8 %) have achieved over 75 % agreement. These statements can provide a practical guide for ophthalmologists to provide the optimal care of patients when multifocal IOL implantation is considered when performing cataract surgery or refractive lensectomy.