Researchers at Emory Eye Center and Emory Vision (Emory University, Atlanta) recently investigated the outcomes of cataract surgery performed with multifocal intraocular lenses (IOLs). The purpose of the study was to determine reasons for patient dissatisfaction with the procedure and the outcomes after remedial actions are taken.
The researchers reviewed the cases of 32 patients who were dissatisfied with the outcomes of their cataract surgery with multifocal IOL implantation.
Most eyes (65 percent) had received an AcrySof ReSTOR IOL (Alcon) and the others (35 percent) received a ReZoom Multifocal IOL (Abbott Medical Optics).
Outcomes analyzed included type of visual complaint, the remedial treatment applied to address the complaint, and the degree of improvement after intervention.
Findings of the study included:
- Thirty patients (94 percent) reported blurred vision.
- Fifteen patients (47 percent) reported photic phenomena (visual disturbances caused by optical aberrations; also called “negative dysphotopsia”).
- Thirteen patients (41 percent) reported both blurred vision and photic phenomena.
Causes of blurred vision included:
- Posterior capsule opacification, or “PCO” (22 eyes, 54 percent)
- Residual nearsightedness, farsightedness or astigmatism (12 eyes, 29 percent)
- Dry eye syndrome (6 eyes, 15 percent)
Causes of photic phenomena included:
- PCO (12 eyes, 66 percent)
- IOL decentration (2 eyes, 12 percent)
- Retained lens fragment from the removed cataractous lens (1 eye, 6 percent)
- Dry eye syndrome (1 eye, 6 percent)
Remedial treatments applied to relieve patient symptoms included artificial tears and other dry eye therapy, laser surgery for PCO and surgery for IOL exchange.
Thirty-five eyes (81 percent) had improvement with conservative treatment. Five eyes (12 percent) did not have improvement despite treatment combinations. Three eyes (7 percent) required IOL exchange.
The researchers concluded complaints of blurred vision and photic phenomena after multifocal IOL implantation can be effectively managed with appropriate treatment, though a few eyes may require IOL exchange.
The study was supported in part by Research to Prevent Blindness and the National Institutes of Health.
Source: Dissatisfaction after multifocal intraocular lens implantation. Journal of Cataract and Refractive Surgery. June 2009.
Tags: Cataract Surgery Complications, intraocular lenses, multifocal IOLs, ReSTOR, ReZoom