YAG laser capsulotomy in multifocal intraocular lenses

Introduction: Multifocal intraocular lenses (MIOLs) have been implanted wit h good results for several years. Because the light is distributed between two or more focuses, there is slight light reduction for every picture. Cap sular fibrosis can cause additional reduction of the amount of light to the retina. Patients and methods: A diffractive MIOL 811X from Pharmacia & Upjohn was i mplanted in 40 eyes of 40 patients. Within 1 year postoperatively, 13 patie nts underwent YAG laser capsulotomy between the 4th and the 6th month. Befo re and after the YAG laser the visual acuity for distance and near vision w as tested. In addition, a contrast test (Ginsburg test) was performed. Results: Before YAG laser capsulotomy, the visual acuity for distance witho ut correction was 0.5 (+/- 0.17) and near vision J 2.4 (+/- 1.4). After the YAG laser procedure, uncorrected visual acuity improved to 0.65 (+/- 0.21) for distance and J 1 (+/- 0) for near vision. With the best distance corre ction the distance vision was 0.85 (+/- 0.18) and near vision was J 1.77 (/- 0.89) before capsulotomy. After the YAG laser treatment, patients reache d with best correction a visual acuity of 1.1 (+/- 0.24) at distance and J 1 (+/- 0) at near vision. The contrast equivalent acuity increased from 20/ 70 before the YAG laser treatment to 20/40 after ward. Discussion: Patients with a MIOL feel early visual discomfort due to capsul ar fibrosis. In most cases the patients still have good visual acuity, but decreased contrast sensitivity. Early YAG laser capsulotomy increases the v isual acuity and the contrast sensitivity significantly.