June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Dissatisfaction after multifocal intraocular lens implantation
Author Affiliations & Notes
    Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Lara Asroui
    Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Tanner Ferguson
    Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • James Bradley Randleman
    Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Footnotes
    Commercial Relationships   IMANE TARIB None; Lara Asroui None; Tanner Ferguson None; James Randleman None
  • Footnotes
    Support  NONE
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 3307. doi:
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      IMANE TARIB, Lara Asroui, Tanner Ferguson, James Bradley Randleman; Dissatisfaction after multifocal intraocular lens implantation. Invest. Ophthalmol. Vis. Sci. 2023;64(8):3307.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose : To analyze dissatisfaction prevalence amongst patients implanted with multifocal Intraocular lenses (MFIOL)

Methods : Retrospective study at the Cole Eye Institute, Cleveland Clinic. We conducted a review of electronic medical records EPIC to identify all patients implanted with MFIOLs since 2017, by 12 surgeons. A statistical analysis of demographic data and IOL type was performed. We analyzed postoperative findings in the first year after surgery and determined patient satisfaction based on reported needs and symptoms: Satisfied, mostly satisfied (spectacles needed for one distance only and/or occasional visual symptoms), dissatisfied (spectacles needed for more than one distance and/or frequent visual symptoms requiring further treatment) and IOL exchange

Results : 313 eyes of 170 patients were included, 15 of which were referred for IOL dissatisfaction management. 96 females (55%) and 81 males (45%), mean age of 67 years old. The implantation was unilateral in 27 patients and bilateral in 143. Panoptix in 131 eyes (41.8%), Symfony in 116 (37%), Vivity in 57 (18.2%) and Restor in 9 (2.9%). The mean UDVA was 20/25 and mean CDVA 20/20. Of all patients eyes: 38% (n=119) were satisfied, 37.7% (n=118) mostly satisfied, 16.3% (n=51) dissatisfied, and 8% (n=21) required IOL exchange.
Higher satisfaction rates were observed in the Panoptix group (47.3%) and higher IOL exchange in Symfony group (11.21%). Spectacles and complemental treatments such as contact lens, dry eye management, YAG laser capsulotomy, IOL repositioning and PRK or LASIK were required in the dissatisfied category. IOL exchanges were required in 25 patients due to extreme dysphotopsia, blurry vision or both, 10 of which were postoperative referrals. Low correlation was found between Satisfaction and postoperative spherical equivalent (0.29) and with postoperative cylinder (+0.5 and below =0.11, +0.75 and above =0.28)

Conclusions : Patients with dissatisfaction after MFIOL implantation can be effectively managed with appropriate treatments, such as laser corneal refractive surgery that can be effective in most cases. However, some patients still require IOL exchange to achieve resolution of their debilitating symptoms, an option that MFIOL surgeons should be able to offer, should their patients require it

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.


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