Late intraocular lens exchange in dissatisfied patients with multifocal intraocular lens implantation

Yu-Wei Kuo; Yu-Chih Hou

doi:10.4103/tjo.tjo_55_20

Late intraocular lens exchange in dissatisfied patients with multifocal intraocular lens implantation

Taiwan J Ophthalmol. 2020 Oct 7;12(1):109-112. doi: 10.4103/tjo.tjo_55_20. eCollection 2022 Jan-Mar.

Authors

Yu-Wei Kuo¹, Yu-Chih Hou^{1

2

3}

Affiliations

¹ Department of Ophthalmology, Cathay General Hospital, Taipei, Taiwan.
² Department of Ophthalmology, College of Medicine, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan.
³ Department of Ophthalmology, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.

Abstract

Intraocular lens (IOL) exchange may be required after multifocal IOL implantation due to dissatisfaction. Late IOL exchange is more challenging when it is done with capsulotomy. We presented a retrospective case series study enrolling four consecutive eyes reviewing late IOL exchange due to decreased vision and dysphotopsia. High residual hyperopia, astigmatism, and IOL tilt occurred in 3 eyes, respectively. The mean time to the IOL exchange was 15.8 ± 10.63 months. After separation of the adhesions by visco-dissection assisted with a 27-gaze needle and sinskey hook, IOL was explanted. One-piece IOL was implanted in the bag in two eyes without posterior capsulotomy, whereas three-piece IOL was implanted in the sulcus after viscoelastic tamponade in the other 2 eyes with capsulotomy. No complication occurred and dysphotopsia disappeared. The mean logarithm of the minimum angle of resolution best-corrected visual acuity significantly improved from 0.33 ± 0.12 preoperatively to 0.11 ± 0.13 postoperatively. In conclusion, late IOL exchange could be safely performed with proper technique and achieve good results.

Keywords: Capsulotomy; intraocular lens exchange; multifocal intraocular lenses; optic capture.

Publication types

Case Reports