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Prevalence of Presbyopia-Correcting Intraocular Lens Satisfaction, Dissatisfaction, and Intolerance.

Bianca N Susanna1,2,3, Molly J E Snider1, Bassel Hammoud1

  • 1Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio.

Journal of Refractive Surgery (Thorofare, N.J. : 1995)
|November 10, 2025
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Summary

Most patients are satisfied with presbyopia-correcting intraocular lenses (PrC-IOLs), but 12.8% experience dissatisfaction, often due to blurry vision or photic phenomena. Some symptoms resolve spontaneously, while others may require IOL exchange.

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Area of Science:

  • Ophthalmology
  • Refractive Surgery
  • Biomaterials Science

Background:

  • Presbyopia-correcting intraocular lenses (PrC-IOLs) offer improved near and distance vision but can be associated with visual disturbances.
  • Understanding patient satisfaction and the causes of dissatisfaction is crucial for optimizing outcomes in cataract and refractive surgery.

Purpose of the Study:

  • To determine the prevalence of satisfaction, dissatisfaction, and intolerance following PrC-IOL implantation.
  • To identify the primary reasons for patient dissatisfaction with PrC-IOLs.
  • To assess the rate of spontaneous resolution for photic phenomena after PrC-IOL surgery.

Main Methods:

  • A retrospective cross-sectional study was conducted on 493 patients who received various types of PrC-IOLs (bifocal, trifocal, diffractive EDOF, non-diffractive EDOF).
  • Data collected included refractive outcomes, patient-reported satisfaction/dissatisfaction, causes of dissatisfaction, management strategies, IOL exchange rates, and photic phenomena resolution.
  • Follow-up data were analyzed for spontaneous resolution of photic phenomena over time.

Main Results:

  • Overall satisfaction with PrC-IOLs was high at 87.2%.
  • Dissatisfaction was reported by 12.8% of patients, with 7.7% being intolerant; blurry vision (73%) and photic phenomena (50.8%) were the main drivers.
  • Spontaneous resolution of photic phenomena occurred in 43% of cases within one year, primarily between 6-12 months. IOL exchange was performed in 2.4%.

Conclusions:

  • While most patients achieve satisfaction with PrC-IOLs, a significant minority experience dissatisfaction or intolerance, primarily linked to visual disturbances.
  • Photic phenomena show partial spontaneous resolution, but outcomes are less favorable in dissatisfied patients.
  • Management strategies, including potential IOL exchange, are important for addressing persistent dissatisfaction after PrC-IOL implantation.