Visual Outcomes and Patient Satisfaction After Presbyopic Lens Exchange With a Diffractive Multifocal Intraocular Lens

PURPOSE: To investigate the visual outcomes, severity of symptoms, and patient satisfaction after refractive lens exchange (RLE) with a diffractive multifocal intraocular lens (IOL). METHODS: A nonrandomized, unmasked, retrospective chart review study was performed. Patients who underwent RLE with ZMA00 (Abbott Laboratories) were identified from a hospital database. Eyes with preoperative uncorrected distance visual acuity or corrected distance visual acuity 20/20 or better were included. The study cohort comprised 45 eyes from 29 patients. Monocular uncorrected and distance-corrected visual acuity at distance, 67 cm, and 30 cm were measured 6 months postoperatively. A patient questionnaire assessing visual symptoms (halo, night glare, and starburst) and satisfaction with visual performance was administered. RESULTS: Six months postoperatively, mean uncorrected visual acuity (logMAR) was -0.10 +/- 0.13, 0.43 +/- 0.25 at 67 m (intermediate), and 0.18 +/- 0.05 at 30 m (near). Mean distance-corrected visual acuity at these distances was -0.02 +/- 0.06, 0.40 +/- 0.21, and 0.17 +/- 0.02, respectively. Twenty-seven patients completed the questionnaire. Patients reported postoperative halos (78%), night glare (26%), and starbursts (48%). All bilateral RLE patients were spectacle-free at all distances, whereas 50% of unilateral RLE patients required spectacles postoperatively. Bilateral RLE patients with habitual spectacle use preoperatively were the most satisfied with their postoperative visual performance. CONCLUSIONS: Refractive lens exchange with the ZMA00 is an option for presbyopic correction; however, significant glare, halo, and starburst issues are subjectively reported. [J Refract Surg. 2012;28(7):468-474.] doi:10.3928/1081597X-20120612-01