Posters

Residual refractive error after multifocal intraocular lens implantation: causes and treatment

Poster Details

First Author: M.Bohač CROATIA

Co Author(s):    A. Barisic   N. Gabric   S. Patel              

Abstract Details

Purpose:

To evaluate reasons that lead to residual refractive error after the refractive lens exchange (RLE) with multifocal intraocular lens(MIOL)  implantation and efficacy of laser vision correction in such cases.

Setting:

Specialty Eye Hospital Svjetlost, School of Medicine University of Rijeka, Zagreb, Croatia

Methods:

Out of 823 cases of RLE with various MIOL implantation; 30 eyes(20 patients) had residual refractive error.12 eyes had Tecnis Symfony EDOF IOL(2 toric), 6 eyes had Reviol TriED IOL, 4 eyes had Zeiss AT LISA IOL, 4 eyes had Tecnis multifocal(ZKB00, ZLB00) diffractive IOL, and 2 eyes had Presbysmart IOL implanted. LASIK was performed between 3 and 6 months after RLE. Intralase 150Hz was used for flap creation and Schwind Amaris 750S(Aberration Free program) for excimer laser ablation. Distance and near uncorrected visual acuity(UDVA, UNVA), manifest refraction and subjective satisfaction were measured before LASIK and 3 months after LASIK.

Results:

Out of 30 eyes 22 eyes had mainly cylindrical residual refractive error.Average cylinder axis was placed at 100°.Mean UDVA before LASIK was 0.68±0.21(range 0.2 to 1.0) decimal Snellen,mean UNVA was J1.85±1.08(J5 to J1),mean sphere was 0.31±0.86D(-1.75 to +2.00D),mean cylinder was -0.89±0.69D(-3.00 to -0.00D).Mean UDVA after LASIK was 0.98±0.08(0.6 to 1.0),mean UNVA was J1.41±0.50(J2 to J1), mean sphere was 0.05±0.27D(-0.25 to +1.00D),mean cylinder was -0.15±0.19(-0.50 to 0.00D).One patient(1 eye) with Reviol TriEd IOL needed additional enhancement due to unsatisfactory UNVA.Patients reported higher satisfaction after LASIK and decrease in visual disturbances.

Conclusions:

Residual refractive error was the main cause of patients dissatisfaction after RLE.  Majority of residual refractive errors came from surgically induced astigmatism and inaccurate biometric calculation in short eyes. LASIK with Aberration Free program is safe and effective in correction of residual refractive error after RLE with MIOL implantation.

Financial Disclosure:

None