Diffractive trifocal lens implantation with or without excimer laser enhancement: is a touch-up procedure a negative predictor for refractive and subjective outcome?

Abstract

PURPOSE:

To investigate the refractive results of a LASIK enhancement and its impact on treatment safety, efficacy, predictability and patient reported outcome in eyes after clear lens extraction and diffractive trifocal lens implantation.

METHODS:

A retrospective cohort multicentre study of Care Vision Refractive Centres in Germany compared two groups of patients. Group 1 consisted of eyes that had non-toric MIOL surgery only, whereas group 2 had a consecutive laser enhancement after 3 months follow-up. Refractive and subjective results of the two groups were compared. Patient reported outcome measurements were assessed by using a 30-item questionnaire with four subscales. (Spectacle Dependence, Eye Comfort, Freedom and Looking/Feeling Well). Refractive results were reported following standard reporting in refractive surgery.

RESULTS:

139 eyes of 79 patients were included in which either MIOL surgery or MIOL surgery plus LASIK enhancement had been performed between January and December 2017. UDVA reached 0.1logMAR (0.8; 20/25) in 94% in group 2 and 85% in group 1. Compared to preoperative CDVA no change in Snellen lines of CDVA was shown in 89% in group 1 and in 93% in group 2. Spectacle dependence (P = 0.41), eye comfort (P = 0.15), freedom (P = 0.48) and looking/feeling well (P = 0.45) showed no statistically significant difference between both the groups.

CONCLUSIONS:

In patients with residual ametropia after MIOL implantation, LASIK provides a reliable, safe and efficient way to achieve the desired refractive outcome and patient satisfaction. We recommend performing Laser enhancement at 3 months after MIOL implantation (Bioptics) in trifocal MIOL patients that benefit from improvement of residual ametropia.

• Authors: Anne-Karen von Beckerath, Toam Katz, Anna Harfst, Vasyl Druchkiv, Andreas Frings
• Journal: Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie (Graefes Arch Clin Exp Ophthalmol) Vol. 258 Issue 5 Pg. 1115-1121 (May 2020) ISSN: 1435-702X [Electronic] Germany
• PMID: 32076835 (Publication Type: Journal Article, Multicenter Study)

Topics

• Adult
• Female
• Humans
• Hyperopia (physiopathology, surgery)
• Keratomileusis, Laser In Situ (methods)
• Lasers, Excimer (therapeutic use)
• Lens Implantation, Intraocular
• Male
• Middle Aged
• Multifocal Intraocular Lenses
• Myopia (physiopathology, surgery)
• Patient Satisfaction
• Phacoemulsification
• Pseudophakia (physiopathology)
• Refraction, Ocular (physiology)
• Refractive Errors (physiopathology)
• Retrospective Studies
• Surveys and Questionnaires
• Visual Acuity (physiology)
• Young Adult