Clinical Outcomes after Exchange of Diffractive Multifocal Intraocular Lenses with Monofocal Intraocular Lenses

Purpose: To determine the clinical outcomes after exchange of diffractive multifocal intraocular lenses (IOLs) with monofocal IOLs for patients who complained of dysphotopsia after cataract surgery. Methods: We exchanged the IOLs of patients who visited our clinic complaining that dysphotopsia had not improved after they underwent phacoemulsification and diffractive multifocal IOL implants in local eye clinics. We evaluated the corrected distance visual acuity (CDVA) before and after operation, the type of preoperative dysphotopsia, postoperative dysphotopsia status, patient satisfaction, and all complications. Results: We enrolled 35 eyes of 27 patients and observed them for 5.7 +/- 3.6 months. After 1 month, the CDVA significantly (p < 0.001) improved from 0.131 +/- 0.131 logarithm of the minimal angle resolution (logMAR) preoperatively to 0.0328 +/- 0.0900 logMAR postoperatively. Patient satisfaction graded on a scale from 1 (very dissatisfied) to 5 (excellent) significantly (p < 0.001) increased from 1.17 +/- 0.382 preoperatively to 4.09 +/- 0.818 postoperatively. No vision-threatening complications developed. Postoperative cystoid macular edema developed in one eye but resolved after intravitreal bevacizumab (Avastin (R), Genetech, Inc, San Francisco, CA, USA) injections. Conclusions: IOL exchange surgery relatively safely improves the vision of patients suffering from dysphotopsia attributable to the characteristics of diffractive multifocal IOLs.