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

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

Correspondence Address:
Yu-Chih Hou,
Department of Ophthalmology, Cathay General Hospital, 280, Ren-Ai Road, Section 4, Taipei
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/tjo.tjo_55_20

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.

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