Multifocal Intraocular Lens Implantation Outcomes: Satisfaction And Dissatisfaction Management

To analyze dissatisfaction prevalence amongst patients implanted with multifocal Intraocular lenses (MFIOL) during cataract surgery.

The Refractive surgery department of the Cole Eye Institute of the Cleveland Clinic, Cleveland, Ohio, United States.

We conducted a retrospective review of our electronic medical records EPIC to identify all the patients implanted with MFIOLs since 2017, by 12 surgeons, in our center. A statistical analysis of demographic data and IOL type was done. We analyzed postoperative exams findings in the first year after surgery and determined patient satisfaction based on need for spectacles, visual symptoms, and need for complemental treatments such as refractive surgery or IOL exchange.

We classified patients into 3 categories: Satisfied, mostly satisfied (spectacles needed for one distance only and/or occasional visual symptoms), dissatisfied (spectacles needed for more than one distance, frequent visual symptoms and IOL exchange).

287 eyes from 161 patients. 66 patients (119 eyes) (40.99%) in Group (1), 61 patients (112 eyes) (37.8%) in Group (2), and 34 patients eyes (56 eyes) (21.11%) in Group (3) including the ones requiring IOL exchange.

The highest rate in Group (1) was observed with Trifocal IOL with 49.6%. In Group (2) were comparable between the Bifocal and the W-EDOF groups with 62.5% and 60.7% respectively. As for the Group (3), the highest rate was found in the Bifocal group with 25%. IOL exchange was still required in 5 patients from our institute (8 eyes, 2.78%) for persistent blurry vision and dysphotopsia.

MFIOLs provide great results for the majority of patients. However, dissatisfied patients may sometimes suffer from complications imposing an IOL exchange surgery. Therefore, surgeons offering MFIOL should be able to offer MFIOL explantation as a last resort in case of intolerable visual complaints not responding to other treatments.