title: Multifocal intraocular lens explantation: a case series of 50 eyes.
abstract: OBJECTIVE
  To assess the visual complaints, reasons, and patient satisfaction for multifocal intraocular lens (IOL) explantation.
  
  
  METHODS
  Retrospective observational case series.
  
  
  METHODS
  This study evaluated 50 eyes of 37 patients who underwent multifocal IOL explantation followed by IOL implantation. Before and 3 months after IOL exchange surgery, we investigated the symptoms, reasons, patient demographics, clinical results, and patient satisfaction in eyes undergoing multifocal IOL explantation. Data collected included preoperative subjective and objective findings, reasons, IOL type, postoperative course, and patient satisfaction.
  
  
  RESULTS
  The most common complaints for IOL explantation were waxy vision, followed by glare and halos, blurred vision at far, dysphotopsia, blurred vision at near, and blurred vision at intermediate. The most common reasons for IOL explantation were decreased contrast sensitivity, followed by photic phenomenon, unknown origin including neuroadaptation failure, incorrect IOL power, preoperative excessive expectation, IOL dislocation/decentration, and anisometropia. The axial length was 25.13±1.83 mm. Of the explanted multifocal IOLs, 84% were diffractive and 16% were refractive. Monofocal IOLs accounted for 90% of the exchanged IOLs. Patient satisfaction was significantly improved from 1.22±0.55 preoperatively to 3.78±0.97 postoperatively, which was graded on a scale of 1 (very dissatisfied) to 5 (very satisfied) (Wilcoxon signed-rank test, P<.001).
  
  
  CONCLUSIONS
  Multifocal IOL explantation was required in some patients undergoing multifocal IOL implantation. IOL exchange surgery appears to be a feasible surgical option for dissatisfied patients with persistent visual symptoms after multifocal IOL implantation.
authors.affiliation: Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan. Electronic address: kamiyak-tky@umin.ac.jp.
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Kamiya
authors.affiliation: Department of Ophthalmology, Hayashi Eye Hospital, Fukuoka, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Hayashi
authors.affiliation: Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan.
authors.forename: Kimiya
authors.initials: K
authors.lastname: Shimizu
authors.affiliation: Department of Ophthalmology, Keio University, Tokyo, Japan.
authors.forename: Kazuno
authors.initials: K
authors.lastname: Negishi
authors.affiliation: Department of Ophthalmology, Mito Regional Medical Education Center, Tsukuba University Hospital / Mito Kyodo General Hospital, Ibaraki, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Sato
authors.affiliation: Department of Ophthalmology, Tokyo Dental College Suidobashi Hospital, Tokyo, Japan.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Bissen-Miyajima
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020878:Device Removal / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D011474:Prosthesis Design; D012030:Refractive Errors / Q000209:etiology*; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome