Refractive lens exchange with spherical diffractive intraocular lens implantation after hyperopic laser in situ keratomileusis

Purpose

To assess the safety, efficacy, and predictability in eyes that had refractive lens exchange (RLE) with implantation of a spherical diffractive intraocular lens (IOL) after previous hyperopic laser in situ keratomileusis (LASIK).

Setting

Fernández-Vega Ophthalmological Institute, Oviedo, Spain.

Methods

This prospective study evaluated eyes that had RLE and implantation of an AcrySof ReSTOR SN60D3 IOL after hyperopic LASIK. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected near visual acuity (UNVA), distance-corrected near visual acuity (DCNVA), and residual refractive errors were analyzed using vector analysis and recorded preoperatively and 6 months postoperatively.

Results

The study evaluated 41 eyes of 23 patients. The mean UDVA was 0.189 logMAR ± 0.175 (SD) preoperatively and 0.113 ± 0.101 logMAR 6 months postoperatively (P = .009) and the mean CDVA, 0.049 ± 0.071 logMAR and 0.046 ± 0.063 logMAR, respectively (P = .44). At 6 months, the efficacy index was 0.87 and the safety index, 1.00. The mean UNVA was 0.014 ± 0.026 logMAR, with an efficacy index of 1.00. There were no differences in corrected near visual acuity between preoperatively (with spectacle addition) and postoperatively (P = .3); the safety index was 1.01. All eyes were within ±1.25 diopters (D) of the targeted refraction and 73.17% were within ±0.50 D. The mean postoperative spherical equivalent was −0.064 ± 0.513 D.

Conclusion

Implantation of a spherical multifocal IOL after hyperopic LASIK was safe, effective, and predictable.