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      Dissatisfaction after multifocal intraocular lens implantation

      research-article

      , MD, , MD, , MD, PhD

      Journal of cataract and refractive surgery

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          Abstract

          PURPOSE

          To analyze the reasons for patient dissatisfaction after phacoemulsification with multifocal intraocular lens (IOL) implantation and the outcomes after intervention.

          SETTING

          Emory Eye Center, Atlanta, Georgia, USA.

          METHODS

          This retrospective review comprised eyes of patients dissatisfied with visual outcomes after multifocal IOL implantation. Outcomes analyzed included type of visual complaint, treatment modality for each complaint, and degree of clinical improvement after intervention.

          RESULTS

          Thirty-two patients (43 eyes) reported unwanted visual symptoms after multifocal IOL implantation, including in 28 eyes (65%) with an AcrySof ReSTOR IOL and 15 (35%) with a ReZoom IOL. Thirty patients (41 eyes) reported blurred vision, 15 (18 eyes) reported photic phenomena, and 13 (16 eyes) reported both. Causes of blurred vision included ametropia (12 eyes, 29%), dry eye syndrome (6 eyes, 15%), posterior capsule opacification (PCO) (22 eyes, 54%), and unexplained etiology (1 eye, 2%). Causes of photic phenomena included IOL decentration (2 eyes, 12%), retained lens fragment (1 eye, 6%), PCO (12 eyes, 66%), dry-eye syndrome (1 eye, 2%), and unexplained etiology (2 eyes, 11%). Photic phenomena attributed to PCO also caused blurred vision. Thirty-five eyes (81%) had improvement with conservative treatment. Five eyes (12%) did not have improvement despite treatment combinations. Three eyes (7%) required IOL exchange.

          CONCLUSIONS

          Complaints of blurred vision and photic phenomena after multifocal IOL implantation were effectively managed with appropriate treatment. Few eyes (7%) required IOL exchange. Neodymium:YAG capsulotomy should be delayed until it has been determined that IOL exchange will not be necessary.

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          Author and article information

          Journal
          8604171
          5175
          J Cataract Refract Surg
          J Cataract Refract Surg
          Journal of cataract and refractive surgery
          0886-3350
          1873-4502
          18 November 2016
          June 2009
          28 November 2016
          : 35
          : 6
          : 992-997
          Affiliations
          Emory Eye Center and Emory Vision, Atlanta, Georgia, USA.
          Author notes
          Corresponding author: Maria A. Woodward, MD, 1365 B Clifton Road Northeast, Suite 4500, Atlanta, Georgia 30322, USA. mwoodwa@ 123456emory.edu
          Article
          PMC5125020 PMC5125020 5125020 nihpa239371
          10.1016/j.jcrs.2009.01.031
          5125020
          19465282
          25372fc4-e442-426f-839b-42a42af2614f
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          Article

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