Patients’dissatisfaction with multifocal intraocular lenses managed by exchange with other multifocal lenses of diferent optical profles

Background:The aim of the study was to evaluate the outcomes of dissatisfed patients reporting poor visual quality following implantation of multifocal intraocular lenses(MF-IOLs),managed by IOL exchange with another multifocal optical profle.Methods:This is a retrospective series of cases.MF-IOL exchange was done in 15 dissatisfed patients(30 eyes)with the perception of poor visual quality for far distance afected by neuroadaptation failure.Patients underwent a bilateral exchange of a MF-IOL with another MF-IOL of a diferent optical profle.Visual outcomes and complications were analyzed.Questionnaires including Quality of Vision(QoV),Visual Function Index-14(VF-14)and its Rasch-revised version(VF-8R)and a satisfaction questionnaire were also used for outcome evaluation.Results:The mean elapsed time from implantation to explantation-reimplantation was 11.8 months.The QoV scores improved signifcantly across all the three subscales.Visual function improved with a change in VF-14 score from 60.41±24.81 to 90.16±10.91(P<0.001).The VF-8R score improved as well.The uncorrected distance visual acuity improved from 0.24 to 0.12 logMAR after exchange(P<0.001)and corrected distance visual acuity improved from 0.15 to 0.04 logMAR(P<0.001).Safety and efcacy indexes reached 1.46 and 1.16,respectively.Concerning patients’satisfaction following MF-IOL exchange,80%of the patients reported they would have the MF-IOL reimplantation procedure again.Conclusions:Patient dissatisfaction with neuroadaptation failure following MF-IOL implantation can be managed in 80%of our cases by MF-IOL exchange with a diferent MF-IOL optical profle.