Implantation of a multifocal IOL in myopic eyes that had previously undergone laser refractive surgery resulted in good visual acuity and refractive results in a study.
Use of multifocal IOLs in patients with previous corneal refractive correction is controversial, because power calculation is complicated by the altered ratio of posterior-anterior corneal curvature induced by the laser, the authors noted.
There is also concern that the two procedures together could lead to too much deterioration of contrast sensitivity and quality of vision. However, patients who are strongly motivated to be spectacle independent should not be deprived of this opportunity when the technology for accurate IOL selection and power calculation (ie, corneal topography and biometry) is available, they wrote.
Seventy-seven eyes of 43 patients were retrospectively analyzed. All patients underwent cataract surgery with implantation of an Alcon Acrysof Restor IOL between 2008 and 2015 in one center in The Netherlands. Previous refractive surgery had been performed via LASIK, laser epithelial keratomileusis or PRK.
Results were good in terms of refraction and visual acuity. Safety and predictability were high, with 57% of the eyes within + 0.5D and 86% within + 1.0 D of emmetropia.
“These results are comparable to those of monofocal IOL implantation after corneal refractive laser surgery,” the authors wrote.
Sixteen eyes (20.8%) had laser enhancement, but there was a downward trend from the beginning to the end of the study, due to the improved accuracy of the American Society for Cataract and Refractive Surgery calculator and implementation of multifocal toric IOL technology by the end of 2010. Results were less predictable in eyes with myopia greater than 6.0 D, they said. – by Michela Cimberle
Disclosure: Vrijman has no conflict of interest. Please see the study for the other authors’ financial disclosures.