Refractive outcomes after multifocal intraocular lens exchange. Issue 6 (June 2017)

• Record Type: Journal Article
• Authors: Kim, Eric J.; Sajjad, Ahmar; de Oca, Ildamaris Montes; Koch, Douglas D.; Wang, Li; Weikert, Mitchell P.; Al‐Mohtaseb, Zaina N.
• Is Part Of: Journal of cataract and refractive surgery. Volume 43:Issue 6(2017)
• Publication Date: 2017-06
• Subjects: 617.7
• DOI: 10.1016/j.jcrs.2017.03.034
• Languages: English
• ISSNs: 0886-3350

Abstract

Abstract : Purpose : To evaluate the refractive outcomes after multifocal intraocular lens (IOL) exchange. Setting : Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, USA. Design : Retrospective case series. Methods : Patients had multifocal IOL explantation followed by IOL implantation. Outcome measures included type of IOL, surgical indication, corrected distance visual acuity (CDVA), and refractive prediction error. Results : The study comprised 29 patients (35 eyes). The types of IOLs implanted after multifocal IOL explantation included in‐the‐bag IOLs (74%), iris‐sutured IOLs (6%), sulcus‐fixated IOLs with optic capture (9%), sulcus‐fixated IOLs without optic capture (9%), and anterior chamber IOLs (3%). The surgical indication for exchange included blurred vision (60%), photic phenomena (57%), photophobia (9%), loss of contrast sensitivity (3%), and multiple complaints (29%). The CDVA was 20/40 or better in 94% of eyes before the exchange and 100% of eyes after the exchange ( P = .12). The mean refractive prediction error significantly decreased from 0.22 ± 0.81 diopter (D) before the exchange to −0.09 ± 0.53 D after the exchange ( P < .05). The median absolute refractive prediction error significantly decreased from 0.43 D before the exchange to 0.23 D after the exchange ( P < .05). Conclusions : Multifocal IOL exchange can be performed safely with good visual outcomes using different types of IOLs. A lower refractive prediction error and a higher likelihood of 20/40 or better vision can be achieved with the implantation of the second IOL compared with the original multifocal IOL, regardless of the final IOL position.