J Korean Ophthalmol Soc.  2014 Dec;55(12):1779-1786. 10.3341/jkos.2014.55.12.1779.

Clinical Results and Optical Quality of Diffractive Multifocal IOL Implantation after Myopic Refractive Surgery

Affiliations
  • 1Busan Sungmo Eye Hospital, Busan, Korea. pinmed@hanmail.net

Abstract

PURPOSE
To evaluate the visual outcome and optical quality in eyes with diffractive multifocal intraocular lens (DMIOL) implantation after myopic refractive surgery.
METHODS
Nineteen eyes (15 patients) were implanted with AcriSof ReSTOR(R) SN6AD1, the aspheric DMIOL after myopic refractive surgery (laser-assisted in situ keratomileusis [LASIK] 14 eyes, photorefractive keratectomy [PRK] 4 eyes, laser-assisted subepithelial keratomileusis [LASEK] 1 eye). Preoperative and postoperative visual acuities and manifest refraction were measured. Preoperative corneal higher-order aberrations (HOAs) were measured using Hartmann-Shack (H-S) aberrometer in dilated pupils, and optical qualities were measured 1 month postoperatively using H-S aberrometer and a double-pass system under mesopic conditions. Patient satisfaction was investigated using a questionnaire at 2 months postoperatively.
RESULTS
Uncorrected distant and near visual acuities at postoperative 2 months were 0.11 +/- 0.19, and 0.19 +/- 0.12 (log MAR), respectively. Postoperative spherical equivalent (SE) of 16 eyes (84.2%) was within +/-0.50 diopters (D) and all eyes were within +/-1.00 D from emmetropia. Preoperative corneal and postoperative ocular spherical aberrations in a 4.0 mm pupil diameter were 0.08 +/- 0.08 and 0.07 +/- 0.07 (microm), respectively. Objective scatter index was 3.42 +/- 1.71 and modulation transfer function (MTF) cut-off value was 21.03 +/- 12.37 cpd. General satisfaction score was 3.52 +/- 0.96 points out of 5, and 8 patients (11 eyes) were not satisfied with DMIOL implantation.
CONCLUSIONS
After DMIOL implantation in the eyes with previous myopic refractive surgery, postoperative SE was close to the target D, but optical qualities and patient satisfaction were poor.

Keyword

Aspherical diffractive multifocal intraocular lens; Higher-order aberration; Myopic refractive surgery; Optical quality

MeSH Terms

Emmetropia
Humans
Keratectomy, Subepithelial, Laser-Assisted
Lenses, Intraocular
Patient Satisfaction
Photorefractive Keratectomy
Pupil
Surveys and Questionnaires
Refractive Surgical Procedures*
Visual Acuity

Figure

  • Figure 1. Visual acuity after the diffractive multifocal intraocular lens (IOL) implantation. (A) Uncorrected distance visual acuity (UDVA). (B) Uncorrected near visual acuity (UNVA).

  • Figure 2. Postoperative spherical equivalent of the patients who had implanted the diffractive multifocal intraocular lens (IOL).


Reference

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