Diffractive multifocal intraocular lens interferes with intraoperative view

Abstract

We report an unusual finding during vitreous surgery in an eye implanted with adiffractive multifocal intraocular lens (IOL). A 70-year-old woman reported gradual visualdeterioration to 20/40 in the left eye two and a half years after uneventful cataract surgery withimplantation of a diffractive multifocal IOL. Funduscopic examination showed an epiretinalmembrane (ERM) in the left eye. Increased macular traction was believed to cause the visualdeterioration. Vitreous surgery with removal of the ERM was performed and triamcinoloneacetonide (TA) was injected intravitreally to visualize the residual vitreous cortex. Althoughthe ERM was peeled successfully, the ability to focus on the vitreoretinal interface through theIOL required great effort with decreased contrast sensitivity and ghost images of the intravitrealTA crystals. The vision improved to 20/25 4 months postoperatively. Macular surgery can beperformed in an eye with a diffractive multifocal IOL; however, decreased contrast sensitivityand ghost images may interfere with the intraoperative view through the diffractive IOL incomplicated cases.© 2010 Yoshino et al, publisher and licensee Dove Medical Press Ltd.