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Benefit from the latest advance in optics for cataract after post-refractive surgery

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First Author: A.Méal FRANCE

Co Author(s):    A. Meal   B. Cochener-Lamard                 

Abstract Details

Purpose:

Evaluation of bilateral implantation of a trifocal hydrophobic IOL with extended focal zones, the POD L GF TRIUMF ®(FineVision) for cataract surgery after refractive surgery (KR, PRK or lasik). Discussion of calculation methods and measurement of visual outcome.

Setting:

University Brest hospital – France

Methods:

15 patients (30  eyes) were enrolled in a controlled prospective observational open unicenter study. Calculation of the IOL refractive power was based on the K-1 formula from the flattest central keratometry, Haigis and Barrett TK suite formula in addition to the online calculators available on the ASCRS website. Results are reported at 1 and 3 months and include visual performances at 35 cm, 60 cm and 4 m , defocus curve and assessment of vision quality using i.tracey® aberrometry, questionnaire of life, MTF and Salzburg Reading Chart ®.

Results:

Population consists of 8 post-KR, 3 post-PRK, 4 post-Lasik. 84% of the population are within +/- 0.75D of the emmetropia target and 42% are within +/- 0.50D. Spectacle independence is achieved in 72% of cases, while 10% require intermittent near correction and 18% require distance and near correction for certain activities due to residual ametropia (particularly cylindrical). Moderate halos and glare are reported in 40% of cases, especially in the KR group, while symptomatic dry eye is noted in 30% of cases. 82% were satisfied with the surgery when 18% expected an optimal result.

Conclusions:

The challenge of managing cataracts after refractive corneal surgery is based on the difficulty in ensuring an accurate calculation of IOL power and on corneal changes impacting corneal surface and quality of vision. The strategy for lens calculation in post-corneal surgery benefits from specific formulas, superior to that of K-1 and the clinical history. The new optics combining trifocality and extension of focal zones allows better tolerance of residual refractive error than previous generations of multifocal lenses. Their indication after corneal refractive surgery in patients who are demanding of maintaining their glasses independence appears to be an option of interest.

Financial Disclosure:

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