Managing dissatisfaction after multifocal intraocular lens implantation through lens exchange using monofocal or alternative multifocal IOLs

Abstract

AbstractPurposeTo manage patient dissatisfaction following multifocal intraocular lens (MF‐IOL) implantation by IOL exchange with either a monofocal or an alternative MF‐IOL, and to compare outcomes in these two groups.MethodsMF‐IOL exchange was performed in 32 patients (64 eyes) with neuroadaptation failure. The MF‐to‐MF group involved patients who had a MF‐IOL exchanged with another MF‐IOL of a different optical profile and the MF‐to‐MO group involved patients who had a MF‐IOL exchanged to a monofocal IOL. Visual outcomes and complications were analysed. The Quality of Vision (QoV) questionnaire, Visual Function Index (VF‐14) and its Rasch‐revised version (VF‐8R) were also used to assess outcomes.ResultsThere were no significant differences (p > 0.05) in the QoV scores between the two groups, both preoperatively and postoperatively. Preoperatively, there were no significant differences in VF‐14 scores between both groups (p > 0.05). Postoperatively, there were statistically significant differences in VF‐14 (total score, intermediate vision and near vision) in favour of the MF‐to‐MF group (p < 0.05). The postoperative VF‐8R score in the MF‐to‐MF group was significantly better than the MF‐to‐MO group (p ≤ 0.001). Uncorrected and corrected near as well as corrected distance visual acuities were significantly better (p < 0.05) in the MF‐to‐MF group compared to the MF‐to‐MO group at 3 months.ConclusionPatient dissatisfaction and neuroadaptation failure following MF‐IOL implantation can be managed by an IOL exchange with an alternative optical design of MF‐IOL or a monofocal IOL. Although, in the current study, the MF‐to‐MF group showed some better postoperative results, both options are feasible solutions.