Dissatisfication After Multifocal IOL Implantation in Taiwan
Purpose
To compare the reasons of patients’ dissatisfaction after bilateral implantation of multifocal to monofocal intraocular lens (IOL).
Methods
A prospectively randomized comparative clinical study included patients with IOL implantation who had visual complaints, photic phenomena, or no improvement of vision-related quality of life (VR-QOL) postoperatively. Two study groups were multifocal and monofocal. Complete ophthalmologic examinations were performed, including visual function, biometry, refraction, ocular surface, IOL-related and vitreo-retinal assessment, the report of dysphotopsia and VR-QOL 1 month preoperatively and 3 months postoperatively. The main outcome measures were type of complaints, refractive state, posterior capsular opacity, and ocular co-morbidity.
Results
A total of 564 cases participated in this study. 160 cases (28%) reported blurred vision (multifocal n=75; monofocal n=85) and 109 cases (19.3%) had photic phenomena (multifocal n=66 ; monofocal n=43). 61 cases presented both symptoms (10.8%) (multifocal n=33 ; monofocal n=28). The 3 most significant causes were dry eye, posterior capsule opaocification (PCO), and residual ametropia. The incidence of dry eye and PCO were higher in the multifocal group, whereas the incidence of ametropia was more significant in the other group (p < .05). The duration of performing Nd-YAG capsulotomy after surgery showed no differences in both groups.
Conclusion
The cause of dissatisfaction after multifocal IOL implantation can be identified and effective measures can be taken in most case.