Dissatisfaction after implantation of multifocal intraocular lenses

TLDR

The study aimed to identify the symptoms, causes, and management options for patient dissatisfaction following multifocal intraocular lens implantation. A retrospective chart review of 76 eyes from 49 patients assessed complaints, visual acuities, refractive status, pupil size, and wavefront aberrometry to determine etiologies and treatment outcomes. Blurred vision and photic phenomena were reported in 94.7 % and 38.2 % of eyes, respectively, with residual ametropia, astigmatism, posterior capsule opacification, and large pupils being the main causes; 84.2 % of eyes responded to treatments such as refractive surgery, spectacles, or laser capsulotomy, and only 4 % required IOL exchange, demonstrating that most dissatisfaction can be effectively addressed.

Abstract

To analyze the symptoms, etiology, and treatment of patient dissatisfaction after multifocal intraocular lens (IOL) implantation.Department of Ophthalmology, Maastricht University Medical Center, The Netherlands.Case series.In this retrospective chart review, the main outcome measures were type of complaints, uncorrected and corrected distance visual acuities, uncorrected and distance-corrected near visual acuities, refractive state, pupil diameter and wavefront aberrometry measurements, and type of treatment.Seventy-six eyes of 49 patients were included. Blurred vision (with or without photic phenomenon) was reported in 72 eyes (94.7%) and photic phenomena (with or without blurred vision) in 29 eyes (38.2%). Both symptoms were present in 25 eyes (32.9%). Residual ametropia and astigmatism, posterior capsule opacification, and a large pupil were the 3 most significant etiologies. Sixty-four eyes (84.2%) were amenable to therapy, with refractive surgery, spectacles, and laser capsulotomy the most frequent treatment modalities. Intraocular lens exchange was performed in 3 cases (4.0%).The cause of dissatisfaction after implantation of a multifocal IOL can be identified and effective treatment measures taken in most cases.