[Correction of suboptimal outcomes after cataract surgery using secondarily implanted AddOn intraocular lenses]

Introduction: Today, the expectation for cataract surgery is to achieve the best possible refractive outcome, but ultimately in many cases the visual outcome is suboptimal, which may require further surgical correction. Often the most optimal option for surgical correction is the implantation of a secondary supplementary lens in the ciliary sulcus. Aim: The aim of our study was to assess the long-term visual outcome after secondary implantation of the 1stQ AddOn® (Medicontur Medical Engeneering Ltd.) artificial lens in the sulcus, focusing on its stability and biocompatibility. Method: We analyzed the data of patients with suboptimal visual outcomes after cataract surgery who underwent implantation of a monofocal 1stQ AddOn lens as a corrective procedure. Pre- and postoperative evaluations included uncorrected and corrected distance vision, objective and subjective (manifest) refraction, corneal endothelial cell density, and complex slit-lamp ophthalmologic examination including applanation intraocular pressure measurement. The positions of the primary and secondary lenses were assessed via ultrasound biomicroscopy 1–4 years after implantation. Statistical comparisons were performed using an unpaired two-sample t-test or Wilcoxon test. The limit of significance was 5%. Results: 14 eyes from 12 patients (mean follow-up: 34,34 ± 16,13 months) were studied. The uncorrected logMAR visual acuity significantly improved at both 1 month (p = 0,0002) and 1–4 years (p = 0,0001) postoperatively, while the corrected acuity remained stable. Endothelial cell counts did not differ significantly from preoperative values. No increases in intraocular pressure, chronic inflammation, pigment dispersion, or other complications were observed. The secondary lenses remained stable, with a mean inter-lens distance of 0,38 ± 0,16 mm. Discussion: In patients with suboptimal visual outcome after cataract surgery, 1stQ AddOn lens implantation is well planned and provides a stable long-term outcome without complications. Conclusion: Secondary lens implantation is a suitable alternative for postoperative correction in cases of suboptimal visual outcome. Orv Hetil. 2025; 166(26): 1031–1037.