Limited vitrectomy may benefit patients with multifocal IOLs, floaters
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Limited vitrectomy may help patients who have undergone multifocal IOL implantation and are experiencing floaters, according to a study.
J. Sebag, MD, FACS, FRCOphth, FARVO, told Healio/OSN that the vitreous is often overlooked in ocular health and contributes to patient unhappiness due to vision-degrading myodesopsia and degraded contrast sensitivity.
“Contrast sensitivity is also degraded by MFIOLs, and it was not known whether patients with MFIOL pseudophakia and vision-degrading myodesopsia would benefit from surgery,” he said.
Sebag and colleagues conducted a prospective, nonrandomized clinical study comprising 180 eyes of 180 patients: 55 with multifocal IOLs (MFIOLs), 60 with monofocal IOLs and 65 with phakic lens status. They assessed vitreous structure with quantitative ultrasonography and vision with visual acuity and contrast sensitivity function measurements.
Eyes with multifocal IOLs had the worst contrast sensitivity function (P < .001).
Among the 86 patients who chose to undergo vitrectomy, vitreous echodensity was 68% greater and contrast sensitivity function was 31% worse than observation controls (both P < .0001). After surgery, vitreous echodensity decreased by 55%, 51% and 52% and contrast sensitivity function improved by 37%, 48% and 43% in multifocal IOL, monofocal IOL and phakic eyes, respectively (P < .0001 for each). In addition, improved visual well-being was observed with the NEI Visual Function Questionnaire.
“Thus, MFIOL patients who are unhappy with their vision should have in-depth vitreous evaluation with ultrasonography — superior to physical exam — in search of vision-degrading myodesopsia,” Sebag said. “If present, this condition can be cured with limited vitrectomy and offers patients and their doctors a new way to address unhappiness with MFIOL pseudophakia.”
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