Vitrectomy for vitreous opacities more common with multifocal IOLs

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Osher JM, et al. Surgical retina for the anterior segment surgeon. Presented at: Cataract Surgery: Telling It Like It Is. June 9-13, 2020; Amelia Island, Florida.

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AMELIA ISLAND, Fla. — Patients with multifocal IOLs are more likely to develop vitreous opacities and have a lower threshold for vitrectomy, according to a presentation at Cataract Surgery: Telling It Like It Is.

“There’s something about multifocal IOLs that makes floaters much more bothersome,” James M. Osher, MD, of Cincinnati Eye Institute, said.

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In a retrospective review of 204 eyes, Osher and colleagues found that patients with multifocal IOLs elected to have vitrectomy more than a year earlier than patients with monofocal IOLs.

“Why is that?” Osher said. “Is it because they paid a couple thousand dollars for their implant, so they have greater expectations and are not going to be tolerant of floaters? Is it because there is a contrast sensitivity issue or a multifocality issue that’s disrupted by the floaters? I don’t know, but these patients are extremely unhappy.”

Osher said these patients’ experiences have changed his threshold for vitrectomy and even combined phacovitrectomy.

“I used to tell patients, ‘You have to be symptomatic for a year, and it has to be impacting part of your life. It can’t just be a nuisance,’” he said. “If I see the type of vitreous that tends to be symptomatic, lots of anterior vitreous condensations, and they want a multifocal IOL, I think they’re great candidates for combined surgery.”

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Elena Johaness

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