Visual Outcomes, Quality of Vision, and Quality of Life of Diffractive Multifocal Intraocular Lens Implantation after Myopic Laser In Situ Keratomileusis: A Prospective, Observational Case Series

Abstract

Purpose. To report visual performance and quality of life after implantation of a bifocal diffractive multifocal intraocular lens (MIOL) in postmyopic laser in situ keratomileusis (LASIK) patients. Methods. Prospective, observational case series. Patients with prior myopic LASIK who had implantation of Tecnis ZMA00/ZMB00 MIOL (Abbott Medical Optics) at Hong Kong Sanatorium and Hospital were included. Postoperative examinations included monocular and binocular distance, intermediate and near visual acuity (VA), and contrast sensitivity; visual symptoms (0–5); satisfaction (1–5); spectacle independence rate; and quality of life. Results. Twenty-three patients (27 eyes) were included. No intraoperative complications developed. Mean monocular uncorrected VA at distance, intermediate, and near were 0.13 ± 0.15 (standard deviation), 0.22 ± 0.15, and 0.16 ± 0.15, respectively. Corresponding mean values for binocular uncorrected VA were 0.00 ± 0.10, 0.08 ± 0.13, and 0.13 ± 0.10, respectively. No eyes lost >1 line of corrected distance VA. Contrast sensitivity at different spatial frequencies between operated and unoperated eyes did not differ significantly (all P > 0.05). Mean score for halos, night glare, starbursts, and satisfaction were 1.46 ± 1.62, 1.85 ± 1.69, 0.78 ± 1.31, and 3.50 ± 1.02, respectively. Eighteen patients (78%) reported complete spectacle independence. Mean composite score of the quality-of-life questionnaire was 90.31 ± 8.50 out of 100. Conclusions. Implantation of the MIOL after myopic LASIK was safe and achieved good visual performance.

Femtosecond laser-assisted cataract surgery with implantation of a diffractive trifocal intraocular lens after laser in situ keratomileusis: a case report

“…The inclusion criteria for multifocal IOL implantation in our eye center are corneal astigmatism of no more than 1.25D, root mean square (RMS) of corneal HOAs within 6.0 mm zone no more than 0.50 mm, and kappa angle no more than 0.29. The criteria are consistent with those in the studies of Monaco [ 12 ] and Mojzis [ 9 ]. In this case, the patient met all the above requirements despite of his myopic LASIK history.…”

“…Post-LASIK patients are often focusing on better visual quality and they are keen to take off spectacles, even after developing cataract. A few studies have reported that the implantation of multifocal IOLs in patients who underwent previous myopic LASIK provided good visual acuities for distance and near range [ 9 ]. The AT LISA tri839MP, a diffractive trifocal preloaded IOL with an asphericity of − 0.18, provides a near addition (add) of + 3.33 D and an intermediate add of + 1.66D.…”

<p>Spectacle Independence in Patients with Prior Radial Keratotomy Following Cataract Surgery: A Case Series</p>

“…Pseudoaccommodative 1 and hybrid monovision 2 provide post-RK patients with depth of focus, but do not correct corneal aberrations that can affect patient satisfaction. Multifocal intraocular lenses (IOLs) can provide good vision at all distances, 3 but there is a high incidence of visual symptoms such as glare and haloes due to the multiple refractive zones of the lens that emphasize the effect of corneal aberrations. 4,5 The IC-8 IOL combines pinhole technology, through the use of an opaque mask composed of polyvinylidene difluoride and carbon nanoparticles with a central 1.36 mm aperture, with an aspheric hydrophobic acrylic monofocal lens platform.…”

Clinical outcomes with distance‐dominant multifocal and monofocal intraocular lenses in post‐LASIK cataract surgery planned using an intraoperative aberrometer

“…As such, they are often interested in multifocal IOL implantation, although some surgeons are hesitant to use them because of the greater difficulty in achieving an emmetropic result in post‐LASIK eyes. Studies have shown that providing good distance, intermediate and near vision is possible with multifocal IOLs while still maintaining a good safety profile . We are unaware of any study addressing the use of a distant‐dominant multifocal IOL in patients with a history of LASIK.…”

“…Studies have shown that providing good distance, intermediate and near vision is possible with multifocal IOLs while still maintaining a good safety profile. [11][12][13][14] We are unaware of any study addressing the use of a distant-dominant multifocal IOL in patients with a history of LASIK.…”