J Korean Ophthalmol Soc.  2012 Dec;53(12):1777-1782. 10.3341/jkos.2012.53.12.1777.

The Long-Term Refractive Change after Cataract Surgery in Myopic Patients with a History of LASIK

• Yum HR
• Kim MS

• KMID: 2216390
• DOI: http://doi.org/10.3341/jkos.2012.53.12.1777

Abstract

PURPOSE
To evaluate the long-term change of postoperative refraction after cataract surgery in patients with a history of LASIK.
METHODS
A retrospective chart review was performed on 40 eyes of 28 patients who had undergone cataract surgery with a history of LASIK, and 40 eyes of 31 patients who had undergone cataract surgery without LASIK. We evaluated preoperative target refraction, and postoperative refraction during the 2-year follow-up period.
RESULTS
In the group with a history of LASIK, the target refraction was -1.00 +/- 0.98 D, the 2-month postoperative spherical equivalent was -0.53 +/- 1.92 D, and the 2-year postoperative spherical equivalent was -1.03 +/- 1.84 D. In the group with cataract surgery only, the target refraction was -1.44 +/- 1.06 D, the 2-month postoperative spherical equivalent was -1.07 +/- 1.27 D, and the 2-year postoperative spherical equivalent was -0.97 +/- 1.28 D. The difference in mean spherical equivalent at 2 months postoperatively and at 2 years postoperatively between the 2 groups was statistically significant (p = 0.037). The difference in mean spherical equivalent preoperatively and 2 years postoperatively between the 2 groups was statistically significant (p = 0.002). In the group with cataract surgery only, the postoperative refraction shifted to hyperopic refractive power, and was statistically significant. In the group with a history of LASIK, there were no statistically significant differences between preoperative and postoperative refraction. There were no statistically significant differences according to the cataract type in the group with a history of LASIK. The greater the myopic preoperative spherical equivalent was, the shorter the duration between LASIK and cataract surgery, which was significant in the group with a history of LASIK.
CONCLUSIONS
The long-term refractive change after cataract surgery was statistically significant between the cataract surgery after LASIK group and the cataract surgery alone group.

Keyword

Cataract surgery; LASIK; Myopia; Refraction

MeSH Terms

Cataract
Eye
Follow-Up Studies
Humans
Keratomileusis, Laser In Situ
Myopia
Retrospective Studies

Figure

• 

  Figure 1 Changes in mean spherical equivalent preoperatively and at 2 months and 2 years postoperatively in the group of cataract surgery after LASIK and the group of cataract surgery alone. *p < 0.05, paired t-test.

• 

  Figure 2 Scatter grams of preoperative spherical equivalent and time interval between cataract surgery and LASIK shows positive linear regression (Pearson correlation analysis, r2 = 0.478, p = 0.002).

Reference

1. Seitz B, Langenbucher A, Nguyen NX, et al. Underestimation of intraocular lens power for cataract surgery after myopic photorefractive keratectomy. Ophthalmology. 1999. 106:693–702.

2. Masket S, Masket SE. Simple regression formula for intraocular lens power adjustment in eyes requiring cataract surgery after excimer laser photoablation. J Cataract Refract Surg. 2006. 32:430–434.

3. Koch DD. New options for IOL calculations after refractive surgery. J Cataract Refract Surg. 2006. 32:371–372.

4. Langenbucher A, Haigis W, Seitz B. Difficult lens power calculations. Curr Opin Ophthalmol. 2004. 15:1–9.

5. Hamilton DR, Hardten DR. Cataract surgery in patients with prior refractive surgery. Curr Opin Ophthalmol. 2003. 14:44–53.

6. Helmy SA, Salah A, Badawy TT, Sidky AN. Photorefractive keratectomy and laser in situ keratomileusis for myopia between 6.00 and 10.00 diopters. J Refract Surg. 1996. 12:417–421.

7. Brint SF, Ostrick DM, Fisher C, et al. Six-month results of the multicenter phase I study of excimer laser myopic keratomileusis. J Cataract Refract Surg. 1994. 20:610–615.

8. Price FW Jr, Whitson WE, Gonzales JS, et al. Automated lamellar keratomileusis in situ for myopia. J Refract Surg. 1996. 12:29–35.

9. Chayet AS, Assil KK, Montes M, et al. Regression and its mechanisms after laser in situ keratomileusis in moderate and high myopia. Ophthalmology. 1998. 105:1194–1199.

10. McCarthy M, Gavanski GM, Paton KE, Holland SP. Intraocular lens power calculations after myopic laser refractive surgery: a comparison of methods in 173 eyes. Ophthalmology. 2011. 118:940–944.

11. Tsang CS, Chong GS, Yiu EP, Ho CK. Intraocular lens power calculation formulas in Chinese eyes with high axial myopia. J Cataract Refract Surg. 2003. 29:1358–1364.

12. Zaldivar R, Shultz MC, Davidorf JM, Holladay JT. Intraocular lens power calculations in patients with extreme myopia. J Cataract Refract Surg. 2000. 26:668–674.

13. Salah T, Waring GO 3rd, el Maghraby A, et al. Excimer laser in situ keratomileusis under a corneal flap for myopia of 2 to 20 diopters. Am J Ophthalmol. 1996. 121:143–155.

14. Magallanes R, Shah S, Zadok D, et al. Stability after laser in situ keratomileusis in moderately and extremely myopic eyes. J Cataract Refract Surg. 2001. 27:1007–1012.

15. Praveen MR, Shah GD, Vasavada AR, et al. A study to explore the risk factors for the early onset of cataract in India. Eye (Lond). 2010. 24:686–694.

16. Jeon S, Kim HS. Clinical characteristics and outcomes of cataract surgery in highly myopic Koreans. Korean J Ophthalmol. 2011. 25:84–89.