Abstract

Volume.124 Number.6

Original article : Clinical science

Explantation of Diffractive Bifocal Intraocular Lens or Extended Depth of Focus Intraocular Lens
Ryu Takabatake, Makiko Takahashi
Takabatake West Eye Clinic

Purpose: This retrospective study aimed to examine patients in whom a diffractive bifocal intraocular lens (IOL) -TECNIS Multifocal lens (bifocal IOL) -and those in whom an extended depth of focus IOL-TECNIS Symfony (EDOF IOL) -were removed.
Subjects and methods: We included 1218 patients who were implanted with bifocal IOLs (2182 eyes) and 770 patients who were implanted with EDOF IOLs (1290 eyes) between June 2017 and May 2019 at Takabatake West Eye Clinic. Among these, patients in whom IOLs were removed and exchanged were selected and examined.
Results: Overall, 62 patients aged 63.2±7.5 years had bifocal IOL removal (72 eyes) due to symptoms such as waxy vision (42 eyes, 58.3%) and glare and halos (22 eyes, 30.6%). Among the 14 patients aged 65.6±8.3 years who had EDOF IOL removal (16 eyes), glare and halos (13 eyes, 81.3%) were the most common reason for removal, followed by waxy vision (4 eyes, 25%). The removal rate of EDOF IOLs was significantly lower than that of bifocal IOLs (1.2% vs. 3.3%; p<0.001). The removal rate of EDOF IOLs due to waxy vision was significantly lower than that of bifocal IOLs (0.3% vs. 1.9%; p<0.001). Both bifocal IOL and EDOF IOL exchanges significantly improved the corrected distance visual acuity (p<0.001 and p=0.046, respectively) and increased the contrast sensitivity in patients with decreased contrast sensitivity (p<0.001 and p=0.008, respectively).
Conclusion: The results showed that the EDOF IOL is less likely to induce waxy vision due to reduced contrast sensitivity and thus may result in lesser proportion of maladaptive cases on patients with cataract compared with bifocal IOLs.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 124: 494-500, 2020.

Key words
Multifocal intraocular lens removal, Contrast sensitivity, Waxy vision
Reprint requests to
Ryu Takabatake, M. D. Takabatake West Eye Clinic. 138-101 Tanaka, Kita-ku, Okayama 700-0951, Japan