Visual outcomes of multifocal IOL implantation in cataract patients with and without previous refractive surgery

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Shmuel Levinger

ENAIM Medical and Refractive Centres, Israel

: Int J Ophthalmic Pathol

Abstract

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Background: Since LASIK was introduced about three decades ago, an estimated 28 million LASIK surgeries have been performed worldwide, and more than 500,000 of those surgeries were performed in Israel. Many of the patients who had refractive surgery 20 years ago have now reached the age of cataract surgery, and seek to continue their spectacle independence. However, patients who have had refractive surgery frequently experience increased optical aberrations, with the cornea itself often becoming multifocal in nature. Placing a multifocal intraocular lens (MFIOL) IOL behind a multifocal cornea may run the risk of a reduction in visual quality. Methods: This is a retrospective compression case series of the cataract surgeries implanted with a MFIOL. Data was abstracted on uncorrected and best corrected visual acuity (UCVA, BCVA). A comparison was made between naïve and post-refractive surgery eyes. Results: We identified 1200 consecutive cataract surgeries: 800 were naïve eyes (group 1) and 400 had previous refractive surgery (group 2). All cataract surgeries were Femtosecond laser-assisted (Lensx or Victus) and performed by a single surgeon. All MFIOLs were manufactured by Fine Vision (Physiol). The formula used was the “Levinger Formula”, which is a modification of the SRKT formula. At 1 month postoperatively, the UCVA was 0.18 (log MAR) in group 1 and 0.23 in group 2 (p=0.1). At that time, there was a negative effect of age in both groups (r= 0.14 p= 0.04). Near UCVA was 2.01 in group 1 and 3.71 in group 2 (p<0.001). BCVA was 0.09 and 0.12 in group 1 and 2 respectively (p=0.06). Conclusion: Implantation of a MFIOL in cataract surgery in eyes with previous refractive surgery is a viable option - achieving good distance UCVA, with the understanding that there is a slight limitation of near UCVA.

Biography

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Shmuel Levinger, is a Member in Professional SOCIETIES Academy of Ophthalmology (AAO) American, International Council Representative of Israel-for the American Academy of Ophthalmology, the Eye M.D. Association (ASCRS). American European Congress of ophthalmology (AECOS), Israel Society of Ophthalmology, Israel Society of Laser Surgery. 2000-present- General Manager of Enaim Medical Center, Jerusalem, Israel.

E-mail: Dr.Ronit@enaim.co.il