A Novel Approach To Presbyopia Correction In Pseudophakia: Secondary Implantation Of A Multifocal Phakic Iol

To report three cases in which a multifocal posterior phakic intraocular lens (M-IPCL) was secondarily implanted in pseudophakic eyes previously implanted with monofocal intraocular lenses (IOLs).

Single-center study conducted at a private ophthalmology clinic in Kyoto, Japan.

This retrospective case series included three women aged 52, 53, and 64 years with prior monofocal IOLs. Case 1 had residual refractive error of −1.75 D and prior YAG capsulotomy. Case 2 had keratoconus, used hard contact lenses, and underwent bilateral toric IOL implantation. Case 3 had a history of epiretinal membrane surgery, monofocal IOL, and YAG capsulotomy. A multifocal IPCL was secondarily implanted in the pseudophakic eye of each case. Outcome measures included uncorrected distance visual acuity (UDVA), uncorrected near visual acuity (UNVA), and contrast sensitivity.

Postoperative UDVA/UNVA in the M-IPCL–implanted eyes were −0.1 logMAR/J2, 0.1/J3, and 0.1/J3 for Cases 1–3, respectively. Contrast sensitivity exceeded the 50s average in Cases 1 and 2 and was slightly below the 60s average in high-frequency range in Case 3. None of the patients required near glasses or reported dysphotopsia.

Secondary M-IPCL implantation may be a useful surgical option for correcting both residual ametropia and presbyopia in pseudophakic eyes, with the added advantage of being removable if monofocal vision is later desired.