Explantation of multifocal IOL frequency, causes and course

Session Details

Session Title: Pseudophakic IOLs: Multifocal & Accommodative

Session Date/Time: Monday 07/09/2015 | 08:00-10:30

Paper Time: 08:12

Venue: Room 1

First Author: : O.Kermani GERMANY

Co Author(s): :    G. Gerten   E. Farvilli   K. Schmiedt   M. Schultz           

Abstract Details

Purpose:

Multifocal intraocular lenses (MF-IOL) are implanted for visual rehabilitation after cataract operation and refractive lens exchange (RLE). In this retrospective study the frequency, the causes and the course of MF-IOL explantation are investigated.

Setting:

Private eye clinic, Cologne, Germany

Methods:

Between 2009 and 2014 a total of 1438 eyes were supplied with a hydrophobic, aspherical, diffractive, multifocal posterior chamber lens (PCL) type: Acrysof ReSTOR and ReSTOR toric with near additions of +2,5, +3,0 and +4,0 (Alcon, Fort Worth, USA). 78% (n =1116) were indicated because of a cataract and 22% (n = 322 eyes) as RLE. All procedures were either performed by OK or GG as an ultrasound phacoemulsification under topical anesthesia. Since 2013 a femtosecond laser (LensX, Alcon, Fort Worth the USA) was used partially. Data analysis was performed with the help of the digital patient's recordings.

Results:

In a total of 12 cases the MF-IOL needed to be explanted. Causes for the explantation were strong deviations of the expected target refraction (4 eyes), epiretinal gliosis accompanied by surgically membrane peeling (2 eyes), optical discomfort (waxy vision) (4 eyes), unstable toric lens due to a vast zonulolysis (1 eye), and five years post implantation glistening (1 eye). A total frequency of MF-IOL explantationen was 0.83%. The frequency of explantations due to specifical optical side effects and discomfort was 0.28%. In all cases 12 months post MF-IOL explantation recovery was achieved to full visual acuity.

Conclusions:

Diffractive MF-IOL of the type Alcon Acrysof ReSTOR are very well accepted all together. In only 0.28% of all cases an explantation was performed on grounds of optical discomfort. In the other cases the causes for the explantation were not related to the optical geometry of the MF-IOL.

Financial Interest:

NONE