Multifocal Intraocular Lens Candidacy In Patients Undergoing Pre-Operative Evaluation For Cataract Surgery In A Public Hospital.

To identify the suitable candidates for multifocal intraocular lens (IOL) implantation in patients undergoing preoperative evaluation for cataract surgery in a public eye hospital “Ophthalmiatreio”

Ophthalmiatrion Athinon Public Eye Hospital

Data were collected during the preoperative patient evaluation. Screening was performed based on patient’s medical record, comprehensive ophthalmic examination, ocular history, optical biometry (Zeiss, IOL Master 700) and Optical Coherence Tomography (Heidelberg, OCT Spectralis) in accordance with the relative indications and contraindications as mentioned at current literature.

The study evaluated 650 consecutive patients with a mean age of 74.40 ± 7.40 (SD) years. One hundred thirty-eight patients (27 %) had monofocal  IOL in the other eye. Of total 512 patients, 216 (42.12%) patients were eligible for receiving a multifocal intraocular lens. Two hundred ninety-six patients (57.8%) had reasons of exclusion in one or both eyes.  Among them 102 (34.5 %) were excluded because of retinal disease, 38 (12.8 %) due to astigmatism (> 1.D of corneal astigmatism), 26 (8.8%) because of glaucoma and 22 (7.14%) due to pseudoexfoliation or zonular instability while in 66 (22.3 %) patients there was more than one reasons of exclusion.  The mean age of good and poor candidates was 72 and 76 years respectively (p<0.01).   

 

More than the one third of the preoperative patients for cataract surgery in a public hospital has no contraindications for multifocal IOL implantation. The most  prominent prevalent contraindication is macular disease.