Trifocal diffractive intraocular lens implantation in patients after previous corneal refractive laser surgery for myopia
Background: With the difficulties in IOL power calculation and the potential side effects occurring postoperatively, multifocal IOL implantation after previous corneal refractive surgery are rarely reported especially for the trifocal IOL. Herein we report the clinical observation of trifocal IOL implantation in patients with previous myopia excimer laser correction. In this study, a multi-formula average method was performed for the IOLs power calculation to improve the accuracy. Visual and refractive outcomes were analyzed, and the subjective quality of patients’ life was evaluated by questionnaires survey.
Methods: This retrospective case series included patients with previous myopia excimer laser correction who underwent femtosecond laser assisted phacoemulsification and trifocal IOL (AT LISA tri 839 MP) implantation. Follow-up was done at 1-day, 1-month and 3-month to assess the visual outcomes. Outcome measures were uncorrected distance, intermediate and near visual acuity (UDVA, UIVA, UNVA), manifest refraction, defocus curve, and subjective quality of vision.
Results: 21 Eyes from sixteen patients (14 eyes with previous laser in situ keratomileusis and 7 eyes with previous photorefractive keratectomy) were included. Mean postoperative spherical equivalent (SE) at 3-month was −0.56 D ± 0.49 SD, wherein, 10 eyes (47.6%) were within ± 0.50 D of the desired emmetropia and 19 eyes (90.5%) were within ± 1.0 D. Mean monocular UDVA, UIVA and UNVA (logMAR) at last visit were 0.02 ± 0.07, 0.10 ± 0.10, and 0.15 ± 0.11 respectively. Three patients (19%) reported halos and glare in postoperative 3 months, two of them needed to use spectacles to improve the intermediate visual acuity. Fifteen patients (94%) reported a satisfaction score of ≥3.5 out of 4.0, without any difficulty in daily activity. Thirteen patients (81%) did not need spectacles at all distances, while the other 3 patients (19%) used spectacles for near-distance related visual activity. Mean composite score of the VF-14 questionnaire was 95.00 ± 7.29 out of 100.
Conclusions: Trifocal IOL implantation after myopia excimer laser correction could restore good distance, intermediate visual acuity and acceptable near visual acuity, and provide accurate refractive outcomes as well as high spectacles independence rate.
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Posted 18 Jun, 2020
On 17 Jul, 2020
On 01 Jul, 2020
On 17 Jun, 2020
On 16 Jun, 2020
On 16 Jun, 2020
On 09 Jun, 2020
Received 08 Jun, 2020
Received 08 Jun, 2020
On 03 Jun, 2020
Received 03 Jun, 2020
On 03 Jun, 2020
Received 29 May, 2020
On 27 May, 2020
On 20 May, 2020
Invitations sent on 18 May, 2020
On 18 May, 2020
On 06 May, 2020
On 05 May, 2020
On 05 May, 2020
On 05 May, 2020
Trifocal diffractive intraocular lens implantation in patients after previous corneal refractive laser surgery for myopia
Posted 18 Jun, 2020
On 17 Jul, 2020
On 01 Jul, 2020
On 17 Jun, 2020
On 16 Jun, 2020
On 16 Jun, 2020
On 09 Jun, 2020
Received 08 Jun, 2020
Received 08 Jun, 2020
On 03 Jun, 2020
Received 03 Jun, 2020
On 03 Jun, 2020
Received 29 May, 2020
On 27 May, 2020
On 20 May, 2020
Invitations sent on 18 May, 2020
On 18 May, 2020
On 06 May, 2020
On 05 May, 2020
On 05 May, 2020
On 05 May, 2020
Background: With the difficulties in IOL power calculation and the potential side effects occurring postoperatively, multifocal IOL implantation after previous corneal refractive surgery are rarely reported especially for the trifocal IOL. Herein we report the clinical observation of trifocal IOL implantation in patients with previous myopia excimer laser correction. In this study, a multi-formula average method was performed for the IOLs power calculation to improve the accuracy. Visual and refractive outcomes were analyzed, and the subjective quality of patients’ life was evaluated by questionnaires survey.
Methods: This retrospective case series included patients with previous myopia excimer laser correction who underwent femtosecond laser assisted phacoemulsification and trifocal IOL (AT LISA tri 839 MP) implantation. Follow-up was done at 1-day, 1-month and 3-month to assess the visual outcomes. Outcome measures were uncorrected distance, intermediate and near visual acuity (UDVA, UIVA, UNVA), manifest refraction, defocus curve, and subjective quality of vision.
Results: 21 Eyes from sixteen patients (14 eyes with previous laser in situ keratomileusis and 7 eyes with previous photorefractive keratectomy) were included. Mean postoperative spherical equivalent (SE) at 3-month was −0.56 D ± 0.49 SD, wherein, 10 eyes (47.6%) were within ± 0.50 D of the desired emmetropia and 19 eyes (90.5%) were within ± 1.0 D. Mean monocular UDVA, UIVA and UNVA (logMAR) at last visit were 0.02 ± 0.07, 0.10 ± 0.10, and 0.15 ± 0.11 respectively. Three patients (19%) reported halos and glare in postoperative 3 months, two of them needed to use spectacles to improve the intermediate visual acuity. Fifteen patients (94%) reported a satisfaction score of ≥3.5 out of 4.0, without any difficulty in daily activity. Thirteen patients (81%) did not need spectacles at all distances, while the other 3 patients (19%) used spectacles for near-distance related visual activity. Mean composite score of the VF-14 questionnaire was 95.00 ± 7.29 out of 100.
Conclusions: Trifocal IOL implantation after myopia excimer laser correction could restore good distance, intermediate visual acuity and acceptable near visual acuity, and provide accurate refractive outcomes as well as high spectacles independence rate.
Figure 1
Figure 2