Outcome after multifocal intraocular lens exchange because of severely impaired quality of vision.

PURPOSE To evaluate the surgical outcome after intraocular lens exchange in patients implanted with a multifocal intraocular lens (MIOL) who presented impairing visual complaints SETTING Department of Ophthalmology, Antwerp University Hospital, Belgium. METHODS 25 eyes of 17 consecutive patients underwent IOL exchange. Pre- and postoperative evaluation consisted of: determining patient's complaints, type of IOL before and after IOL exchange, degree of glare and aberrometry (mainly preoperative data), pre and postoperative DCVA and NCVA. RESULTS Diffractive MIOL were more frequently exchanged than refractive MIOLs and were exchanged when possible by a bag-in-lens IOL. DCVA, NCVA and postoperative subjective complaints improved significantly postoperatively. Eyes with prior Nd:YAG laser capsulotomy needed anterior vitrectomy during MIOL exchange procedure due to the presence of a ruptured anterior vitreous face by the laser treatment. CONCLUSION MIOL exchange can be performed safely and with very good visual outcome in patients with severe postoperative visual complaints related to decentered MIOL. Although, patient's postoperative quality of vision remained poor in 7 eyes out of the 25 in this series.