Dissatisfaction After Bilateral Multifocal Intraocular Lens Implantation: An Electrophysiology Study

PURPOSE: To resolve patient dissatisfaction after bilateral diffractive multifocal intraocular lens (IOL) implantation, a multifocal IOL was exchanged for a monofocal IOL in the dominant eye. The relationship between dissatisfaction and pattern visual evoked cortical potential (P-VECP) was analyzed. METHODS: A 49-year-old man and a 71-year-old woman were implanted with diffractive multifocal IOLs bilaterally. Despite good binocular visual acuity after bilateral multifocal IOL implantation, each patient experienced persistent dissatisfaction with quality and sharpness of vision even when using spectacles and contact lenses. A multifocal IOL was exchanged for a monofocal IOL in the dominant eye of each patient. Pattern visual evoked cortical potential was measured in each patient and the average of each component was calculated. RESULTS: After IOL exchange in the dominant eye, P-VECP amplitude increased, peak latency improved, and the patients' symptoms disappeared. CONCLUSIONS: Monofocal IOL exchange in the dominant eye is an effective approach for dissatisfaction after bilateral multifocal IOL implantation.