Comparison between supplementary intraocular lens and wavefront-guided laser in situ keratomileusis for the correction of refractive errors in pseudophakic patients

Session Details

Session Title: Cataract Surgery Special Cases

Session Date/Time: Sunday 06/09/2015 | 10:30-12:30

Paper Time: 11:42

Venue: Room 10

First Author: : T.Ferreira PORTUGAL

Co Author(s): :    F. Ribeiro   J. Pinheiro   E. Marques              

Abstract Details

Purpose:

To compare visual outcomes in pseudophakic patients undergoing implantation of a supplementary intraocular lens (IOL) or wavefront-guided laser in situ keratomileusis (LASIK) for the correction of residual refractive errors and to develop a decision tree for the treatment of these patients.

Setting:

Clínica Privada de Oftalmologia, Lisbon, Portugal.

Methods:

This comparative case series included pseudophakic patients with myopia or myopic astigmatism following implantation of a supplementary IOL (Sulcoflex Aspheric 653L or Sulcoflex Toric 653T, Rayner Intraocular Lenses Limited) or receiving wavefront-guided LASIK (Technolas 217z, Bausch & Lomb Surgical). 15 patients were included in the IOL group and 18 in the LASIK group. Refractive target was emmetropia. Over a 12-month follow-up period, uncorrected and corrected distance visual acuities (UDVA and CDVA, respectively), spherical equivalent (SE) refraction, higher order aberrations (HOA) and mesopic and photopic contrast sensitivity (CS) with and without glare (Optec 6500, Stereo Optical, Inc.) were evaluated.

Results:

At 12 months, mean UDVA (logMAR) was 0.08 ± 0.05 (Sulcoflex) and 0.06 ± 0.07 (LASIK) (P=.544). Mean SE refraction was -0.28 ± 0.79 (Sulcoflex) and -0.33 ± 0.58 (LASIK) (P=.830). 13 (87%) eyes in the Sulcoflex group and 17 (94%) eyes in the LASIK group were within ±1.00 D of emmetropia. Mean change in SE refraction from 1 week to 12 months was -0.04 ± 0.15 D (Sulcoflex) and -0.25 ± 0.32 D (LASIK); P=004. HOA were similar between groups (HOA RMS 0.39 ± 0.18 (Sulcoflex), 0.29 ± 0.18 (LASIK); P=.234). There was no significant difference in CS except at 18 cd (better in the Sulcoflex group in both mesopic and photopic conditions with and without glare; P=.004).

Conclusions:

Both surgical techniques provided excellent visual outcomes and refractive predictability. Stability of SE correction and CS at higher spatial frequencies (in both mesopic and photopic conditions with and without glare) were better in the Sulcoflex group. Based on these results, a decision tree for selecting one of the two techniques in pseudophakic patients was developed.

Financial Interest:

One of the authors research is funded, fully or partially, by a competing company, One of the authors travel has been funded, fully or partially, by a competing company, One of the authors travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented