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Diffractive optic intraocular lens exchange: indications and outcomes.

Hasan Alsetri1, Don Pham, Samuel Masket

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Surgical exchange of diffractive optic intraocular lenses (IOLs) for monofocal IOLs effectively resolved visual disturbances like diffractive optic dysphotopsia (DOD). This procedure improved or maintained visual acuity, even with pre-existing conditions.

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Area of Science:

  • Ophthalmology
  • Optics
  • Surgical Innovation

Background:

  • Diffractive optic multifocal and extended depth-of-focus intraocular lenses (IOLs) can cause visual disturbances.
  • These disturbances, including diffractive optic dysphotopsia (DOD), may necessitate lens exchange for improved visual quality.

Purpose of the Study:

  • To assess the indications and outcomes of surgically exchanging diffractive optic IOLs for monofocal IOLs.
  • To evaluate the effectiveness of this exchange in resolving patient-reported visual symptoms.

Main Methods:

  • A retrospective chart review of 64 eyes undergoing diffractive optic IOL exchange between June 2007 and October 2020.
  • Evaluation of surgical indications, comorbidities, methods, complications, and visual outcomes.
  • Management of ocular surface disease and ametropia prior to IOL exchange consideration.

Main Results:

  • 83% of eyes had DOD, 78% experienced reduced visual quality, and 19% had night vision difficulties prior to exchange.
  • Following exchange, all eyes were relieved of DOD, and corrected distance visual acuity improved or remained unchanged.
  • The procedure was successful despite various comorbidities, including post-laser refractive surgery and open posterior capsule in some cases.

Conclusions:

  • Diffractive optic IOLs can lead to unsatisfactory visual outcomes.
  • Surgical exchange for monofocal IOLs is an effective strategy to overcome DOD and improve visual function.
  • This exchange can be performed successfully even in the presence of comorbidities or an open posterior capsule.