J Korean Ophthalmol Soc.  2012 Dec;53(12):1742-1748. 10.3341/jkos.2012.53.12.1742.

The Effects of Laser Refractive Surgery for Correcting Residual Refractive Error after Implantation of ReSTOR(R) Multifocal IOL

• Kim SI
• Kim SJ
• Oh JY
• Pak KH
• Kang SJ

• KMID: 2216385
• DOI: http://doi.org/10.3341/jkos.2012.53.12.1742

Abstract

PURPOSE
To evaluate the clinical effects of excimer laser refractive surgery on eyes with residual refractive error after implantation of ReSTOR(R) multifocal intraocular lenses.
METHODS
We retrospectively reviewed the medical records of 10 eyes of 6 patients who had undergone cataract surgery with implantation of multifocal intraocular lenses. Photorefractive keratectomy (PRK) (5 eyes) and laser-assisted in situ keratomileusis (LASIK) (5 eyes) was performed on 10 eyes with residual refractive error.
RESULTS
After cataract surgery and before laser surgery, the mean spherical equivalent (SE) was -0.34 +/- 0.89 D and the mean astigmatism was 2.08 +/- 0.55 D. Six months after laser surgery, the mean SE was -0.33 +/- 0.30 D (p = 0.354) and the mean astigmatism was 0.23 +/- 0.28 D. The changes in astigmatism between paired preoperative and postoperative values were statistically significant (p < 0.0001). At 6 months after surgery, uncorrected distance visual acuity significantly improved to 0.11 +/- 0.10 (log MAR) (p < 0.0001) There were no significant changes in the best corrected distance visual acuity and uncorrected near visual acuity (p = 0.073, p = 0.100).
CONCLUSIONS
On the basis of predictability and stability, excimer laser surgery appears to be a clinically useful procedure to correct residual refractive error after implantation of ReSTOR(R) multifocal intraocular lenses.

Keyword

Astigmatism; LASIK; Multifocal intraocular lens; PRK; ReSTOR(R)

MeSH Terms

Astigmatism
Cataract
Eye
Humans
Keratomileusis, Laser In Situ
Laser Therapy
Lasers, Excimer
Lenses, Intraocular
Medical Records
Photorefractive Keratectomy
Refractive Errors
Refractive Surgical Procedures
Retrospective Studies
Visual Acuity

Figure

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  Figure 1 Spherical equivalent refraction and cylindrical refraction over 6 months after excimer laser surgery to correct residual refractive error. The changes in astigmatism were statistically significant between paired preoperative and postoperative values (*p < 0.05).

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  Figure 2 Time course of uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA) at distance and UCVA at near for 10 eyes with excimer laser surgery. UCVA at distance improved at 1 week after surgery and were stable until 6 months after surgery (*p < 0.05).

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  Figure 3 Predictability of excimer laser surgery for spherical equivalent refraction (SE) and cylinder refraction (C). (A) Predictability of excimer laser surgery for spherical equivalent refraction (SE). (B) Predictability of excimer laser surgery for cylinder refraction (C). After 6 months after surgery, 8 eyes (80%) had a spherical equivalent refraction within ±0.25 D of emmetropia, 1 eyes (10%) were within ±0.25 to 0.50 D of emmetropia and 1 eyes (10%) were within ±0.50 to 0.75 D emmetropia. Seven eyes (70%) had a cylinder refraction within ±0.25 D, 2 eyes (20%) were within ±0.25 to 0.50 D and 1 eyes (10%) were within ±0.50 to 0.75 D.

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  Figure 4 Stability of excimer laser surgery for spherical equivalent refraction (SE) and cylinder refraction (C). (A) Stability of excimer laser surgery for spherical equivalent refraction (SE). (B) Stability of excimer laser surgery for cylinder refraction (C). After 1 month, spherical equivalent refraction and cylinder refraction was stable.

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