Multifocal intraocular lens optic anteriorization capture to correct residual refractive error

To evaluate the efficacy and safety of capturing the intraocular lens (IOL) optic through the anterior capsulorhexis opening in eyes with multifocal IOLs and a residual refractive error.

Hospital Oftalmológico de Brasília, Brasília, Brazil.

Eyes with previous cataract surgery and Tecnis ZM900 multifocal IOL implantation were prospectively analyzed. After at least 1 month, patients had second surgery in which the IOL optic was captured through the anterior capsulorhexis opening to correct the residual refractive error. Preoperative and postoperative examinations at 1 day and 3 months included spherical equivalent (SE); uncorrected distance (UDVA), near (UNVA), and intermediate (UIVA) visual acuities; and corrected distance visual acuity (CDVA).

The study included 16 eyes of 14 patients. The mean UDVA was 0.32 logMAR preoperatively and 0.10 logMAR after anterior optic capture and the mean SE, +1.09 diopters (D) and +0.26 D, respectively; both improvements were statistically significant (P<.001). The change in CDVA and UNVA from before anterior optic capture to the last follow-up was not statistically significant. The UIVA was significantly worse postoperatively (P = .011). No eye lost lines of CDVA. One eye (6.25%) developed glaucoma postoperatively. At the last follow-up, 13 patients (92.85%) were spectacle-independent for near and distance vision.

Early outcomes indicate that anterior optic capture is a safe, accurate procedure in eyes with multifocal IOLs and a mild hyperopic residual refractive error postoperatively.