Outcomes of diffractive multifocal lens implantation following prior corneal laser ablative refractive surgery

Session Details

Session Title: Presented Poster Session: Toric Lenses & IOL Power Calculation

Venue: Poster Village: Pod 1

First Author: : S.Daya UK

Co Author(s): :    M. Espinosa Lagana   C. Sunga                    

Abstract Details

Purpose:

To evaluate the outcomes of diffractive trifocal and bifocal lens implantation in patients with prior corneal laser ablative surgery.

Setting:

Centre for Sight - Ambulatory surgical centre

Methods:

Retrospective study of 89 eyes with prior corneal laser ablative surgery who had diffractive trifocal or bifocal lenses implanted at cataract or refractive lens exchange. Prior evaluation ensured there were no visually destructive asymmetric corneal aberrations. Several methods of lens power calculation were used including the Haigis-L and Holladay 2 formula using K readings from the Pentacam Holladay report. The type of laser eye surgery, visual outcomes (UDVA, CDVA, UNVA UIVA (60 & 80cm) and refractive outcomes were collected at 1 month following surgery. Data about visual symptoms, refractive outcomes, enhancement surgery and complications were also collected.

Results:

Mean age 63 years (42 to 72). 38 eyes had prior Hyperopic surgery (34 Lasik 4 PRK), myopic surgery in 51(46 Lasik 5 PRK). Acrilisa bifocal lens implanted in 5 eyes, and remainder trifocals. (Physiol Finevision or Zeiss ATLisa). Postop at 1M 94% ±1.0D and 82% ±0.5D. Monocular UDVA ≥20/30 in 91%, ≥20/25 in 76% and ≥20/20 in 39%. Monocular UNVA(40cm) at 1M ≥20/30 in 83% and ≥20/25 in 57%. Mean SE 1M was -0.10 D±0.51D, cyl -0.42D±0.47 D. 6 (6.7%) of eyes required postoperative enhancement. 4 laser enhancement (3 Lasik and 1 PRK) and 2 piggyback lenses.

Conclusions:

Diffractive bifocal and trifocal lens implantation, in carefully selected patients who have previously had post corneal laser refractive surgery results in excellent refractive and visual outcomes with low enhancement rates. Special attention to corneal aberrations and lens calculations contribute to good and predictable outcomes.

Financial Disclosure:

... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented