Abstract
Purpose. To study the results of cataract surgery with implantation of multifocal IOLs in patients with various retinal pathologies who underwent vitreoretinal surgery. Material and мethods. Fifteen patients who had previously undergone vitreoretinal interventions for macular hole (n=6), epiretinal membrane (n=4) and retinal detachment (n=5) were observed. The criterion for choosing in favor of multifocal lens implantation was high visual acuity (0.7 or more) after undergoing vitreoretinal surgery. All patients underwent cataract phacoemulsification with implantation of two types of multifocal lenses: I group – IOL with an extended near focus (EDOF) (n=8) and II group – with a multifocal three-focus lens (n=7 eyes), including, in 3 cases – with toric component. In 55% of cases, the operation was performed on both eyes. The age of the patients varied from 34 to 59 years (51.4 ± 6.1 years). Results. Long-distance uncorrected visual acuity varied from 0.7 to 1.0 (0.85±0.25), which did not depend on the type of intraocular lens and correlated with morphological changes in the macular region of the retina. The highest uncorrected visual acuity (0.8±0.14) at an intermediate and near distance (0.75±0.25) was achieved in I group of patients. Postoperative spherical equivalent after 1 month corresponded to the planned target refraction (Em±0.5 diopters) in 14 cases and remained stable during 12 months of observation. In general, subjective satisfaction with MIOL implantation was higher in patients in II group, which was explained by minimal changes in the macular region of the retina. Additional spectacle correction for near was required for a patient of I group with a history of macular rupture, who underwent bilateral multifocal IOL implantation with high uncorrected visual acuity in the distance (OD=1.0 \ OS=1.0) and near (OD=0.6 \ OS=0,5). Conclusion. Implantation of multifocal lenses in patients with a good anatomical and functional outcome of vitreoretinal surgery allows obtaining high and stable functional results. Bilateral implantation of a multifocal lens with an extended near focus in patients with operated macular pathology does not cause specific adaptive difficulties in binocular vision. The choice in favor of multifocal lens implantation in patients with vitreoretinal pathology requires an individual approach and careful selection. Key words: multifocal lens, cataract, macular hole, retinal detachment, epiretinal membrane.
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