Comparative Analysis Of Risk Factors In Unhappy Patients Implanted With Multifocal Intraocular Lenses After Presbyopia-Correcting Cataract Surgery
Published 2023 - 41st Congress of the ESCRS
Reference: FP24.02 | Type: Free paper | DOI: 10.82333/ww6b-zs06
Authors: Woosung Jeon* 1 , Chang Ho Yoon 2 , Joo Youn Oh 2 , Hyuk Jin Choi 3 , Mee Kum Kim 2
1Ophthalmology,Seoul National University College of Medicine,Seoul,Korea, Republic Of;Ophthalmology,Seoul National University Hospital,Seoul,Korea, Republic Of, 2Ophthalmology,Seoul National University College of Medicine,Seoul,Korea, Republic Of;Ophthalmology,Seoul National University Hospital,Seoul,Korea, Republic Of;Laboratory of Ocular Regenerative Medicine and Immunology, Biomedical Research Institute,Seoul,Korea, Republic Of, 3Ophthalmology,Seoul National University College of Medicine,Seoul,Korea, Republic Of;Ophthalmology,Seoul National University Hospital,Seoul,Korea, Republic Of;Laboratory of Ocular Regenerative Medicine and Immunology, Biomedical Research Institute,Seoul,Korea, Republic Of;Ophthalmology,Seoul National University Hospital Healthcare System Gangnam Center,Seoul,Korea, Republic Of
Purpose
We investigated the incidence and risk factors for dissatisfactions depending on the type of multifocal intraocular lenses (MF-IOLs) in presbyopic patients who underwent cataract surgery.
Setting
We retrospectively reviewed the medical records of 387 eyes of 243 patients who had undergone uneventful cataract surgery with MF-IOLs implantation and were followed-up for at least 1 month between July 2009 and August 2022 at department of Ophthalmology in Seoul National University Hospital. Bifocal (ReSTORâ), trifocal (PanOptixâ, AT LISAâ tri) and extended depth-of-focus (EDOF; Symfonyâ) IOLs were implanted in patients.
Methods
The patients were divided into two groups. Patients who complained of dissatisfactions about far or near visions or photic disturbances were included in an unhappy group, while uncomplaining patients were included as a control. The unhappy patients were further divided into 6 sub-groups depending on IOL and dissatisfaction subtypes. Demographics, preoperative visual acuities, biometric indices, proportion of preoperative myopia (<-0.5D), postoperative spherical equivalents (po-SEs), refractive astigmatism and mean absolute error (po-MAEs) were compared in unhappy subgroups to those in corresponding controls as risk factors.
Results
The total incidence of dissatisfactions was 17%. Near vision dissatisfaction was the most frequent in Symfonyâ-eyes, while proportions of photic disturbance and near vision discomfort were the same in PanOptixâ-eyes. Although po-SEs and po-MAEs were not different, postoperative distance and near vision were significantly worse in unhappy groups than in the corresponding controls. Statistically significant flattened cornea, longer axial length and high proportion of preoperative myopia were found in PanOptixâ-eyes with near vision discomfort than in control. For photic disturbances, larger pupil size and higher spherical aberration in Restorâ-eyes and higher corneal astigmatism in PanOptixâ-eyes were found than in control, respectively.
Conclusions
Our study suggests that the dissatisfaction rates can develop by about 17% in MF-IOL implanted eyes, irrespective of subtypes. Near vision dissatisfaction is most common in patients with EDOF IOL implantation, whereas incidence of either photic disturbance or near vision discomfort may similarly occur in trifocal IOL implanted eyes. As risk factors, preoperative myopia seems to be related to unhappy near vision, while corneal aberration appears to be involved in photic disturbance.