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. 2016 Oct 11:10:1965-1970.
doi: 10.2147/OPTH.S114890. eCollection 2016.

Causes and correction of dissatisfaction after implantation of presbyopia-correcting intraocular lenses

Allister Gibbons  1 , Tayyeba K Ali  1 , Daniel P Waren  1 , Kendall E Donaldson  1
Affiliations

Causes and correction of dissatisfaction after implantation of presbyopia-correcting intraocular lenses

Allister Gibbons et al. Clin Ophthalmol. .

Abstract

Purpose: The purpose of this study was to assess the causes and possible solutions for patient dissatisfaction after the implantation of presbyopia-correcting intraocular lenses (IOLs).

Methods: This study was a retrospective review of clinical records. All patients who were seen between January 2009 and December 2013 whose primary reason for consultation was dissatisfaction with visual performance after presbyopia-correcting IOL implantation were included in the study. A single treating physician, who determined the most probable cause of dissatisfaction, decided which interventions to pursue following the initial consultation.

Results: Data from 74 eyes of 49 patients were analyzed. The most common cause for complaint was blurry or foggy vision both for distance and near (68%). Complaints were most frequently attributed to residual refractive error (57%) and dry eye (35%). The most common interventions pursued were treatment of refractive error with glasses or contact lenses (46%) and treatment for dry eye (24%). Corneal laser vision correction was done in 8% of eyes; 7% required an IOL exchange. After the interventions, 45% of patients had completed resolution of symptoms, 23% of patients were partially satisfied with the results, and 32% remained completely dissatisfied with the final results.

Conclusion: The most identifiable causes of dissatisfaction after presbyopia-correcting IOL implantation are residual refractive error and dry eye. Most patients can be managed with conservative treatment, though a significant number of patients remained unsatisfied despite multiple measures.

Keywords: cataract; intraocular lens; multifocal intraocular lens; presbyopia.

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Conflict of interest statement

Dr Donaldson is a consultant for Abbott Medical Optics and Alcon. The other authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Clinical photograph of a patient presenting to our clinic with complaints of blurred vision after cataract surgery with a multifocal IOL. Notes: There is a decentered lens with marked inferior corneal edema due to a broken haptic in the inferior angle. The patient was very satisfied even after an IOL exchange; the corneal edema subsided after the removal of the haptic. Abbreviation: IOL, intraocular lens.
Figure 2
Figure 2
Clinical photograph of a patient presenting to our clinic with complaints of blurred vision after cataract surgery with a multifocal IOL. Note: Signs of anterior basement dystrophy are present; the ocular surface disturbance is more evident when fluorescein is used to stain the cornea. Abbreviation: IOL, intraocular lens.
See this image and copyright information in PMC

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