Dissatisfaction after implantation of multifocal intraocular lenses

J Cataract Refract Surg. 2011 May;37(5):859-65. doi: 10.1016/j.jcrs.2010.11.032. Epub 2011 Mar 11.


Purpose: To analyze the symptoms, etiology, and treatment of patient dissatisfaction after multifocal intraocular lens (IOL) implantation.

Setting: Department of Ophthalmology, Maastricht University Medical Center, The Netherlands.

Design: Case series.

Methods: In this retrospective chart review, the main outcome measures were type of complaints, uncorrected and corrected distance visual acuities, uncorrected and distance-corrected near visual acuities, refractive state, pupil diameter and wavefront aberrometry measurements, and type of treatment.

Results: Seventy-six eyes of 49 patients were included. Blurred vision (with or without photic phenomenon) was reported in 72 eyes (94.7%) and photic phenomena (with or without blurred vision) in 29 eyes (38.2%). Both symptoms were present in 25 eyes (32.9%). Residual ametropia and astigmatism, posterior capsule opacification, and a large pupil were the 3 most significant etiologies. Sixty-four eyes (84.2%) were amenable to therapy, with refractive surgery, spectacles, and laser capsulotomy the most frequent treatment modalities. Intraocular lens exchange was performed in 3 cases (4.0%).

Conclusion: The cause of dissatisfaction after implantation of a multifocal IOL can be identified and effective treatment measures taken in most cases.

MeSH terms

  • Aberrometry
  • Acrylic Resins
  • Axial Length, Eye
  • Depth Perception / physiology
  • Female
  • Humans
  • Lens Implantation, Intraocular*
  • Lenses, Intraocular*
  • Male
  • Middle Aged
  • Patient Satisfaction / statistics & numerical data*
  • Prosthesis Design
  • Pseudophakia / physiopathology*
  • Pupil / physiology
  • Refraction, Ocular / physiology
  • Retrospective Studies
  • Vision Disorders / diagnosis
  • Vision Disorders / physiopathology*
  • Vision Disorders / therapy
  • Visual Acuity / physiology


  • Acrylic Resins