Posters

Multifocal IOLs for post-LASIK eyes: does the same IOL fit post-myopic and post-hyperopic corneas?

Poster Details

First Author: R. Cobo-Soriano SPAIN

Co Author(s):    J. Baviera   J. Ortega-Usobiaga   R. Bilbao-Calabuig   J. Beltran           

Abstract Details

Purpose:

RATIONALE: Laser photorefractive surgery modifies corneal asphericity depending on myopic vs hyperopic ablation but most current multifocal IOLs have a standard aspheric profile originally designed to compensate the low positive spherical aberration of normal and intact corneas. Presbyopia correction of post-keratorefractive-eyes is generally performed by indiscriminate implantation of aspherical multifocal-IOL without considering preexisting corneal aberrations.Purpose:

To compare refractive and visual performance of eyes having a multifocal aspherical refractive-lens-exchange (RLE) with previous hyperopic vs myopic photorefractive procedures.

Setting:

Clinica Baviera Group, Madrid, Spain.

Methods:

Comparative retrospective study evaluating refractive and visual outcomes of 494 eyes that had RLE with a multifocal IOL (4 types of diffractive-aspherical IOLs) and had undergone a previous myopic-LASIK (n=144) and hyperopic-LASIK (n=350) at our Institution (all preoperative data known). We compared both groups preoperative and postoperatively analyzing efficacy, predictability and safety parameters, percentage of enhancement, type of enhancement (myopic vs hyperopic) and percentage of capsulotomy, stratified by lens status (cataract vs clear-lens surgery).

Results:

Comparison of both groups showed that there were no statistical differences regarding efficacy parameters, but predictability was inferior in the myopic group and safety was significantly poorer in the hyperopic group (p<0.05, both comparisons). When stratifying by lens status, the clear-lens-hyperopic subgroup had the poorest results regarding safety parameters. Percentage of enhancement was similar in both groups (23% and 20%) and it was mainly a myopic enhancement (p<0.01), and the rate of capsulotomy, that was 21.3% in the whole sample, it was significantly higher in the hyperopic group (83% vs 17%, p<0.01).

Conclusions:

Aspherical multifocal diffractive IOLs seem to have a poorer visual performance in eyes with previous hyperopic ablation compared with myopic ablation. Future studies and IOL-technology should target the best couple IOL/cornea, addressing aberration analysis in order to maximize the efficacy of these specific and aberrated optical systems.

Financial Disclosure:

NONE