Comparing the Effect of Monofocal and Multifocal Intraocular Lenses on Macular Surgery

Abstract

Aim. To compare the effects of previously implanted monofocal and multifocal intraocular lenses (IOL) on macular surgery. Methods. Seventy eyes of 70 patients with epiretinal membrane (ERM) and symptomatic vitromacular traction syndrome that previously had IOL implantation for cataract surgery were included in this prospective randomized clinical trial. Cases were divided into two groups. Group 1 and Group 2 were composed of eyes with monofocal and multifocal IOLs, respectively. The effects of refraction error and IOL decentration at the time of macular surgery performed for ERM and ILM peeling, according to the lens type, were investigated. Pars plana vitrectomy (PPV) was performed to peel ERM and ILM in all cases. Complete ophthalmological examination, fundus fluorescein angiography, and optical coherence tomography imaging were made to all cases, preoperatively and postoperatively. Results. The mean BCVA in Group 1 and Group 2 improved from 0.69 ± 0.15 and 0.38 ± 0.14 logMAR to 0.40 ± 0.14 and 0.10 ± 0.04 logMAR, respectively, at the 6th month. There was no statistically significant difference between the groups in terms of the mean spherical refraction error (P>0.05) and IOL decentration level (P>0.05). The mean time required for macular surgery in Group 2 was statistically significantly longer than that for Group 1 (P<0.05). There was no statistically significant relationship between IOL decentration and macular surgery time in Group 1 (P>0.05), but there it was found in Group 2 (P<0.05). In Group 2, there was a positive correlation between IOL decentration and macular surgery time. Conclusion. In cases with multifocal IOL implants, especially with lens decentration, the time of macular surgery for ERM and ILM peeling during PPV is longer than that of eyes with monofocal IOL due to fluctuations in the clarity of the surgeon’s view.