Dissatisfaction After Implantation Of Extended Depth Of Focus Intraocular Lenses: A Retrospective Case Series.

To evaluate the symptoms, etiology and treatment of patients’ dissatisfaction after extended depth of focus (EDOF) intraocular lens (IOL) implantation.

Retrospective case series at the University Eye Clinic of the Maastricht University Medical Center, Maastricht, the Netherlands.

In this retrospective case series, all the medical records of post-operative dissatisfied patients who had received an EDOF IOL were reviewed. The main outcome parameters included reasons for dissatisfaction (subjective complaints), objective etiology of complaints, uncorrected and corrected visual acuities for distance, intermediate and near, refraction state and type of treatment.

Out of 202 patients (354 eyes) who underwent implantation with an EDOF IOL, 52 unsatisfied patients (83 eyes) were included in this study. Blurred vision was the main complaint, which was reported in 78 eyes (94%) with or without photic phenomena. Photic phenomenae were reported in 21 eyes (25%). The three major etiologies included: residual ametropia, dry eyes and unmet expectations. Most eyes had complaints based on one single etiology (77%), and 19 eyes (23%) had multiple etiologies. In total, 84% of the eyes received treatment, including artificial tears, spectacles, or refractive surgery enhancement. After treatment, only 12 patients (22 eyes) remained dissatisfied with their EDOF IOL, which comprised 6% of the total patient cohort.

Based on this real-world data study, the dissatisfaction cause after implantation of extended depth of focus IOLs can be identified and in most cases be treated effectively. Only a small amount of patients remain dissatisfied after offered treatment(s).