Impact of posterior vitreous detachment on visual acuity following the implantation of a diffractive multifocal intraocular lens

To investigate the effect of posterior vitreous detachment (PVD) on visual acuity after implantation of a diffractive multifocal intraocular lens (MIOL).Eye Clinic, Okayama, Japan.Retrospective case series.This study evaluated 475 eyes of 475 patients who underwent cataract surgery with a TECNIS® Multifocal ZLB00 lens implant between November 2017 and October 2019. The patients' eyes were classified into the complete PVD group (PVD group) or the control group with no PVD/partial PVD (non-PVD group) and divided into three age categories: 65-69, 70-74, and 75-79 years. The postoperative visual acuity of the PVD and non-PVD groups was compared between and within groups by age.Distance-corrected near visual acuity (DCNVA) was significantly worse in the PVD group than in the non-PVD group in all age categories (P ≤ .029). In the PVD group, both corrected distance visual acuity (CDVA) and DCNVA were significantly worse in the 75-79 years age group than in the 65-69 and 70-74 years age groups (P ≤ .034). CDVA and DCNVA in the non-PVD group did not differ significantly between age categories.The results of this study suggest that complete PVD worsens near visual acuity in eyes with a diffractive MIOL. Furthermore, eyes with complete PVD may show an age-related decline in both CDVA and DCNVA. In particular, eyes ≥75 years of age with complete PVD have a poor visual prognosis and should be given careful consideration when deciding whether to implant a diffractive MIOL.