Analysis of Korean Retinal Specialists’ Opinions on Implanting Diffractive Multifocal Intraocular Lenses in Eyes with Underlying Retinal Diseases

Abstract

Multifocal intraocular lenses (MF-IOLs) are increasingly implanted as the need for good near- and intermediate-distance vision increases. Although retinal disease is known to be a relative contraindication for MF-IOL implantation, there are no detailed guidelines for MF-IOL implantation with respect to the type and severity of retinal diseases/statuses. In this study, because retinal diseases can affect the performance of MF-IOLs, we analyzed the opinions of 111 retinal specialists, who were members of the Korean Retina Society, on the implantation of diffractive MF-IOLs in eyes with 15 retinal diseases/statuses using a web-based survey. For each underlying condition, retinal specialists were asked to rate their approval regarding implantation of MF-IOLs on a scale from 1 (completely disapprove) to 7 (completely approve), under the assumption that there were no known contraindications except for a given retinal disease/status. As a result, retinal specialists disapproved MF-IOL implantation (median value of Likert score < 4) in the eyes with wet age-related macular degeneration, dry age-related macular degeneration with geographic atrophy, proliferative diabetic retinopathy, nonproliferative diabetic retinopathy with macular edema, previous macula-off retinal detachment, previous retinal vein occlusion, and epiretinal membrane, but the scores varied by disease/status. The factors that affected the specialists’ opinions were the type of practice and the frequency of MF-IOL implantation (p = 0.013 and p = 0.021, respectively; one-way ANOVA).

Screening cataract patients in a public hospital for a multifocal intraocular lens implantation

“…There is no unanimity among the experts however, regarding this subject. Although most experts would not implant a multifocal IOL in a patient with wet ARMD or diabetic retinopathy with macular edema a signi cant minority would not object to the implantation of a multifocal IOL in a patient with a non-proliferative diabetic retinopathy without macular edema or resolved central serous chorioretinopathy [17]. Furthermore, a recent review failed to nd convincing evidence that patients with retinal disease should be advised against multifocal IOL [18].. Two hundred and six patients in our sample (26.8%) had more than 1 diopter of astigmatism.…”

Effect of Low Myopia on Near and Distance Vision in Astigmatic Pseudophakic Eyes

“…4,5 또한, 각막이상이나 녹내장, 망막 질환 등이 존재하는 경우 다초점인공수정체를 삽입하기에 부적 합하다. [6][7][8] 난시는 빛이 경선의 축에 따라 다르게 굴절하여 한 점에 맺히지 못하는 상태를 가리키며, 9…”

Short-term clinical outcomes after implantation of monofocal intraocular lens with enhanced intermediate function in eyes with epiretinal membrane

“…However, in a recent retrospective study, implantation of multifocal IOL deteriorated visual quality even in patients with mild ERM without foveal involvement, and corrected visual acuity decreased as the grade of ERM increased 7 . In addition, ERM is one of the diseases for which retinal specialists have disapproved of multifocal IOL implantation, and it is difficult for surgeons to remove the ERM of eyes implanted with multifocal IOLs 8 – 10 .…”