Analysis Of Intolerance Factors Of Multifocal Iol’S. 19 Eyes Are Investigated

We present the results of biometric, topographic and aberometric explorations with OCT swept-source of eyes that presented a major functional discomfort after cataract surgery and multifocal IOL implantation  before lens extraction and reimplantation with monofocal IOL.

Private practice and Vernes institute 36 rue ASSAS 75006 PARIS FRANCE

This retrospective series includes 19 eyes of 16 patients (12 women, 4 men). Mean age was 68 years. The patients were operated on between April 2023 and November 2024. Mean time between the 2 procedures was 27 months (1-48 months). The most frequent complain was a feeling of fog (8 cases), low visual acuity (5 cases), visual discomfort (3 cases) and 3 cases evoked “hell”. Mean pre-operative visual acuity was 20/40 (20/60- 20/25). Mean axial length is 23.44mm (21.54-24.97), mean pupillary diameter is 4.39mm (2.74-6.32), mean tilt was 6.9° (2°-9.44°), mean kappa angle :290m (150-640), mean alpha angle is 520m (300-640). The mean horizontal decentration is 0.18mm (0.09-0.42) and mean vertical 0.47mm (0.11-0.8).

The reimplantation could be done in an intact capsular bag for 2 cases and for 17 cases by sutured scleral fixated IOL’s due to unusable bag (capsulotomy); The symptoms disappeared completelyfor 17 eyes.

Mean post-operative visual acuity is 20/25 (20/40-20/20). Mean tilt of 7° (3.3°-12.97°), mean horizontal off-centering is 0.28mm and mean vertical is 0.22mm (0.02-0.582). We had 1 case of post-operative retinal detachment.

Multifocal implantation requires respecting  contraindications in order to avoid affecting the quality of the post-operative visual function and to strongly alter the goal of this kind of implantation preventing the patients to support more surgery.