Most visual symptoms after multifocal IOL implantation can be treated

J Cataract Refract Surg. 2011;37(5):859-865.

Visual performance can be improved in patients who are dissatisfied after multifocal IOL implantation, a study found.

"Presenting symptoms can be classified as complaints about visual acuity, complaints associated with photic phenomena or a combination," the study authors said. "There are many causes of these complaints, including residual ametropia, [posterior capsule opacification], pupil size and coexisting ocular pathology. However, most causes of dissatisfaction can be treated successfully and explantation of the multifocal IOL appears to be rare."

The retrospective chart review included 76 eyes of 47 patients who reported dissatisfaction with visual results after implantation of a multifocal IOL.

Four eyes had a +3 D ReSTOR IOL (Alcon), 69 had a +4 D ReSTOR IOL (Alcon), two had a Tecnis IOL (Abbott Medical Optics) and one had a ReZoom IOL (AMO).

Blurred vision, with or without photic phenomena, was reported in 72 eyes; photic phenomena, with or without blurred vision, were reported in 29 eyes.

Sixty-four eyes were suitable for treatment; 22 eyes underwent two or more treatment modalities. Three eyes underwent IOL exchange.

PRK was performed in 37 eyes; uncorrected near visual acuity was reported in 28 eyes. Preoperatively, uncorrected near visual acuity was J1 in 10 eyes and J3 or better in 24 eyes. Postoperatively, uncorrected near visual acuity was J1 in 16 eyes and J3 or better in 27 eyes.

Of 14 eyes that received spectacles, mean logMAR uncorrected distance visual acuity was 0.24 and mean corrected distance visual acuity was 0.02. Reading vision was J3 or better in 80% of these patients, the authors reported.