Mixing IOL types in refractive lens exchange boosts patient satisfaction

When it comes to refractive lens exchange (RLE), one size doesn't fit all — and neither does one lens. A retrospective study presented at the American Academy of Ophthalmology's Refractive Surgery Subspecialty Day found that implanting different IOLs in each eye (a "mix-and-match" approach) resulted in higher patient satisfaction and fewer lens exchanges compared to bilateral implantation of the same IOL.

Surgeon R. Luke Rebenitsch, MD, and colleagues analyzed outcomes across three cohorts of 50 RLE patients each: bilateral Tecnis Odyssey, a Synergy/Symfony combination, and an Odyssey/Symfony combination. All groups showed strong uncorrected distance vision, with most patients achieving 20/20 in both eyes, and overall satisfaction was high across the board.

Key Takeaways:

• Mix-and-match groups had lower IOL exchange rates than the bilateral same-lens group
• Approximately 25% of patients still required an IOL exchange, mainly due to intermediate vision or distance contrast issues
• Near vision outcomes were slightly lower in the Odyssey-Symfony group, but patients remained satisfied

Why it matters: RLE patients come in with high expectations, and unlike cataract surgery, spectacle independence can't always be guaranteed. Tailoring lens selection to each patient's unique visual demands — and being prepared to exchange lenses if needed — may be the best path to keeping patients satisfied post-surgery.