Multifocal intraocular lens exchange to monofocal for the management of neuroadaptation failure
Abstract Background The aim of this study was to evaluate visual, refractive, quality of vision, visual function and satisfaction of multifocal intraocular lens (MF-IOL) exchange with a monofocal IOL (MNF-IOL) in dissatisfied patients following MF-IOL implantation. Methods This was a retrospective c...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-11-01
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| Series: | Eye and Vision |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40662-022-00311-4 |
| _version_ | 1811233773969211392 |
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| author | Olena Al-Shymali Jorge L. Alió del Barrio Colm McAlinden Mario Canto Laura Primavera Jorge L. Alio |
| author_facet | Olena Al-Shymali Jorge L. Alió del Barrio Colm McAlinden Mario Canto Laura Primavera Jorge L. Alio |
| author_sort | Olena Al-Shymali |
| collection | DOAJ |
| description | Abstract Background The aim of this study was to evaluate visual, refractive, quality of vision, visual function and satisfaction of multifocal intraocular lens (MF-IOL) exchange with a monofocal IOL (MNF-IOL) in dissatisfied patients following MF-IOL implantation. Methods This was a retrospective case series. Bilateral IOL exchange (MF-IOL to MNF-IOL) was performed in 13 patients (26 eyes) with neuroadaptation failure. Questionnaires including the Quality of Vision (QoV), Visual Function Index (VF-14 and Rasch-revised VF-8R version), and a satisfaction questionnaire were used. Results The mean time for IOL exchange was 15 months. The corrected distance visual acuity (CDVA) improved from 20/26 to 20/23 (P = 0.028). The uncorrected near visual acuity (UNVA) worsened after exchange from 20/47 to 20/62 (P = 0.024). QoV scores improved significantly across all three subscales after exchange. Visual function for far distance improved with a change in VF-14 score from 74.2 ± 24.8 to 90.9 ± 9.1 (P = 0.03). The VF-8R score showed worsening although not statistically significant. Near vision spectacle independence was totally or partially lost in all cases. Ten patients (77%) reported they would not repeat the lens exchange. Safety and efficacy indices changed from 1.23 to 0.85, respectively, at three months to 1.24 (P = 0.871) and 0.89 (P = 0.568), respectively, at one year. Conclusion IOL exchange (multifocal to monofocal) to solve neuroadaptation failure in this case series resulted in significant improvements in dysphotopsia and improved distance visual function. However, UNVA worsened and patient satisfaction after exchange remained suboptimal with 77% claiming they would not repeat the lens exchange, suggesting the value of near vision spectacle independence for these patients. |
| first_indexed | 2024-04-12T11:25:06Z |
| format | Article |
| id | doaj.art-1552c509ebb04d60b16090dee13764ae |
| institution | Directory Open Access Journal |
| issn | 2326-0254 |
| language | English |
| last_indexed | 2024-04-12T11:25:06Z |
| publishDate | 2022-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Eye and Vision |
| spelling | doaj.art-1552c509ebb04d60b16090dee13764ae2022-12-22T03:35:15ZengBMCEye and Vision2326-02542022-11-01911910.1186/s40662-022-00311-4Multifocal intraocular lens exchange to monofocal for the management of neuroadaptation failureOlena Al-Shymali0Jorge L. Alió del Barrio1Colm McAlinden2Mario Canto3Laura Primavera4Jorge L. Alio5Cornea, Cataract and Refractive Surgery Unit, Vissum (Miranza Group)Cornea, Cataract and Refractive Surgery Unit, Vissum (Miranza Group)Department of Ophthalmology, Royal Gwent HospitalCornea, Cataract and Refractive Surgery Unit, Vissum (Miranza Group)Cornea, Cataract and Refractive Surgery Unit, Vissum (Miranza Group)Cornea, Cataract and Refractive Surgery Unit, Vissum (Miranza Group)Abstract Background The aim of this study was to evaluate visual, refractive, quality of vision, visual function and satisfaction of multifocal intraocular lens (MF-IOL) exchange with a monofocal IOL (MNF-IOL) in dissatisfied patients following MF-IOL implantation. Methods This was a retrospective case series. Bilateral IOL exchange (MF-IOL to MNF-IOL) was performed in 13 patients (26 eyes) with neuroadaptation failure. Questionnaires including the Quality of Vision (QoV), Visual Function Index (VF-14 and Rasch-revised VF-8R version), and a satisfaction questionnaire were used. Results The mean time for IOL exchange was 15 months. The corrected distance visual acuity (CDVA) improved from 20/26 to 20/23 (P = 0.028). The uncorrected near visual acuity (UNVA) worsened after exchange from 20/47 to 20/62 (P = 0.024). QoV scores improved significantly across all three subscales after exchange. Visual function for far distance improved with a change in VF-14 score from 74.2 ± 24.8 to 90.9 ± 9.1 (P = 0.03). The VF-8R score showed worsening although not statistically significant. Near vision spectacle independence was totally or partially lost in all cases. Ten patients (77%) reported they would not repeat the lens exchange. Safety and efficacy indices changed from 1.23 to 0.85, respectively, at three months to 1.24 (P = 0.871) and 0.89 (P = 0.568), respectively, at one year. Conclusion IOL exchange (multifocal to monofocal) to solve neuroadaptation failure in this case series resulted in significant improvements in dysphotopsia and improved distance visual function. However, UNVA worsened and patient satisfaction after exchange remained suboptimal with 77% claiming they would not repeat the lens exchange, suggesting the value of near vision spectacle independence for these patients.https://doi.org/10.1186/s40662-022-00311-4Multifocal intraocular lensesMultifocal intraocular lens explantationMonofocal intraocular lensDissatisfaction after multifocal intraocular lens implantationNeuroadaptation failurePatient satisfaction |
| spellingShingle | Olena Al-Shymali Jorge L. Alió del Barrio Colm McAlinden Mario Canto Laura Primavera Jorge L. Alio Multifocal intraocular lens exchange to monofocal for the management of neuroadaptation failure Eye and Vision Multifocal intraocular lenses Multifocal intraocular lens explantation Monofocal intraocular lens Dissatisfaction after multifocal intraocular lens implantation Neuroadaptation failure Patient satisfaction |
| title | Multifocal intraocular lens exchange to monofocal for the management of neuroadaptation failure |
| title_full | Multifocal intraocular lens exchange to monofocal for the management of neuroadaptation failure |
| title_fullStr | Multifocal intraocular lens exchange to monofocal for the management of neuroadaptation failure |
| title_full_unstemmed | Multifocal intraocular lens exchange to monofocal for the management of neuroadaptation failure |
| title_short | Multifocal intraocular lens exchange to monofocal for the management of neuroadaptation failure |
| title_sort | multifocal intraocular lens exchange to monofocal for the management of neuroadaptation failure |
| topic | Multifocal intraocular lenses Multifocal intraocular lens explantation Monofocal intraocular lens Dissatisfaction after multifocal intraocular lens implantation Neuroadaptation failure Patient satisfaction |
| url | https://doi.org/10.1186/s40662-022-00311-4 |
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