Eric J Kim1, Ahmar Sajjad1, Ildamaris Montes de Oca1, Douglas D Koch1, Li Wang1, Mitchell P Weikert1, Zaina N Al-Mohtaseb2. 1. From the Cullen Eye Institute (Kim, Sajjad, Montes de Oca, Koch, Wang, Weikert, Al-Mohtaseb), Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, USA; the Shanxi Eye Hospital (Wang), Taiyuan, Shanxi Province, China. 2. From the Cullen Eye Institute (Kim, Sajjad, Montes de Oca, Koch, Wang, Weikert, Al-Mohtaseb), Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, USA; the Shanxi Eye Hospital (Wang), Taiyuan, Shanxi Province, China. Electronic address: zaina@bcm.edu.
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.
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.
Authors: Stefan Kassumeh; Jannik K Luther; Christian M Wertheimer; Katharina Brandt; Merle S Schenk; Siegfried G Priglinger; Andreas Wartak; Gabriela Apiou-Sbirlea; R Rox Anderson; Reginald Birngruber Journal: Transl Vis Sci Technol Date: 2020-06-25 Impact factor: 3.283