Premium intraocular lens implantation in eyes with vitrectomy done

Abstract

Purpose

Phacoemulsification with premium intraocular lens (IOL) implantation has been increasingly popular in the recent years. However, it is not commonly implanted in eyes who had underwent previous vitrectomy surgery as the contrast sensitivity is thought to be reduced and surgeons are worried about poor visualization of the posterior segment after implantation. Since cataract and vitreoretinal diseases often coexist, premium IOLs should be a considerable option for implantation in carefully selected cases. This study aims at reporting the postoperative near and distance visual acuity and subjective quality of vision in eyes with premium IOLs implantation and vitrectomy done.

Methods

Twenty eyes with posterior vitrectomy and premium IOL implantation from 2006 to 2018 were included. Fourteen eyes were included in Group 1 with patients who underwent a combined phacovitrectomy surgery in the same setting, and six eyes were included in Group 2 with patients who received premium IOL implantation after previous posterior vitrectomy.

Results

Both the postoperative corrected distance and near visual acuity at 1 month, 3 month and 1 year are improved in both groups. The subjective quality of vision as graded by the National Eye Institute Refractive Error Quality of Life Instrument-42 questionnaire also showed high patient satisfaction in both groups.

Conclusion

We conclude that the presence of a multifocal IOL does not impede visualization of the posterior segment during vitrectomy surgery and surgical complications were not raised. With careful patient selection and preoperative assessment, premium IOLs can be a considerable option in patients requiring posterior vitrectomy.

Trial registration

Retrospectively registered with the HKSH Medical Group Research Committee (Ref No. RC-2019-31, Date of registration: December 13, 2019).

This is a preview of subscription content, log in to check access.

Fig. 1

Availability of data and materials/code

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

IOL:

Intraocular lens

NEI RQL-42:

National Eye Institute Refractive Error Quality of Life Instrument-42

RE:

Right eye

LE:

Left eye

PVD:

Posterior vitreous detachment

ERM:

Epiretinal membrane

VH:

Vitreous hemorrhage

RD:

Retinal detachment

VA:

Visual acuity

References

  1. 1.

    Khandelwal SS et al (2019) Effectiveness of multifocal and monofocal intraocular lenses for cataract surgery and lens replacement: a systematic review and meta-analysis. Graefes Arch Clin Exp Ophthalmol 257(5):863–875

    Article  Google Scholar 

  2. 2.

    Cao K et al (2019) Multifocal versus monofocal intraocular lenses for age-related cataract patients: a system review and meta-analysis based on randomized controlled trials. Surv Ophthalmol 64:647–658

    Article  Google Scholar 

  3. 3.

    Javitt JC, Steinert RF (2000) Cataract extraction with multifocal intraocular lens implantation: a multinational clinical trial evaluating clinical, functional, and quality-of-life outcomes. Ophthalmology 107(11):2040–2048

    CAS  Article  Google Scholar 

  4. 4.

    Braga-Mele R et al (2014) Multifocal intraocular lenses: relative indications and contraindications for implantation. J Cataract Refract Surg 40(2):313–322

    Article  Google Scholar 

  5. 5.

    Liu L et al (2018) Retinal-image quality and contrast sensitivity function in eyes with epiretinal membrane: a cross-sectional observational clinical study. BMC Ophthalmol 18(1):290

    Article  Google Scholar 

  6. 6.

    Navarro RM et al (2015) Small-gauge pars plana vitrectomy for the management of symptomatic posterior vitreous detachment after phacoemulsification and multifocal intraocular lens implantation: a pilot study from the Pan-American Collaborative Retina Study Group. J Ophthalmol 2015:156910

    Article  Google Scholar 

  7. 7.

    Sebag J et al (2014) Vitrectomy for floaters: prospective efficacy analyses and retrospective safety profile. Retina 34(6):1062–1068

    Article  Google Scholar 

  8. 8.

    Hadayer A, Jusufbegovic D, Schaal S (2017) Retinal detachment repair through multifocal intraocular lens- overcoming visualization challenge of the peripheral retina. Int J Ophthalmol 10(6):1008–1010

    PubMed  PubMed Central  Google Scholar 

  9. 9.

    Hays RD et al (2003) Psychometric properties of the National Eye Institute-refractive error quality of life instrument. Ophthalmology 110(12):2292–2301

    Article  Google Scholar 

  10. 10.

    Patel SB et al (2019) Short-term outcomes of combined pars plana vitrectomy for epiretinal membrane and phacoemulsification surgery with multifocal intraocular lens implantation. Clin Ophthalmol 13:723–730

    Article  Google Scholar 

  11. 11.

    Patel SB et al (2019) Combined phacoemulsification surgery with multifocal intraocular lens implantation and pars plana vitrectomy for symptomatic vitreous opacities. Retin Cases Brief Rep. https://doi.org/10.1097/ICB.0000000000000873

    Article  PubMed  Google Scholar 

  12. 12.

    Kim M et al (2015) Intraocular lens power estimation in combined phacoemulsification and pars plana vitrectomy in eyes with epiretinal membranes: a case-control study. Yonsei Med J 56(3):805–811

    Article  Google Scholar 

  13. 13.

    Yoshino M et al (2010) Diffractive multifocal intraocular lens interferes with intraoperative view. Clin Ophthalmol 4:467–469

    PubMed  PubMed Central  Google Scholar 

Download references

Funding

There is no funding involved in this research study.

Author information

Affiliations

Authors

Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by CLLW and KKHA. The first draft of the manuscript was written by CLLW and NFSK, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Lok Wan Loraine Chow.

Ethics declarations

Conflict of interest

There are no conflicts of interest involved in this research study.

Ethical approval

Ethics approval was obtained with the HKSH Medical Group Research Committee. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Consent to publish

The participant has consented to the submission of the case report to the journal.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Chow, L.W.L., Fung, N.S.K. & Kwok, K.H.A. Premium intraocular lens implantation in eyes with vitrectomy done. Int Ophthalmol (2020). https://doi.org/10.1007/s10792-020-01478-2

Download citation

Keywords

  • Premium intraocular lens
  • Phacoemulsification
  • Vitrectomy
  • Phacovitrectomy surgery