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Kim, Kim, Oh, Pak, and Kang: The Effects of Laser Refractive Surgery for Correcting Residual Refractive Error after Implantation of ReSTOR® Multifocal IOL
Original Article
Journal of the Korean Ophthalmological Society

Journal of the Korean Ophthalmological Society 2012; 53(12): 1742-1748.

Published online: 17 December 2012

DOI: https://doi.org/10.3341/jkos.2012.53.12.1742

The Effects of Laser Refractive Surgery for Correcting Residual Refractive Error after Implantation of ReSTOR® Multifocal IOL

Sung In Kim, MD1, Suk Jin Kim, MD1, Jae Yoon Oh, MD2, Kyu Hong Pak, MD1, Sug Jae Kang, MD1

1Department of Ophthalmology, Saevit Eye Hospital, Goyang, Korea.

2Anyang Seoul Eye Clinic, Anyang, Korea.

Address reprint requests to Sug Jae Kang, MD. Department of Ophthalmology, Saevit Eye Hospital, #1065 Jungang-ro, Ilsandong-gu, Goyang 410-817, Korea. Tel: 82-31-900-7700, Fax: 82-31-900-7777, glaucoma@hanmail.net

Received 30 June 2012       Accepted 24 November 2012

Copyright © 2012 The Korean Ophthalmological Society

Abstract

Purpose

To evaluate the clinical effects of excimer laser refractive surgery on eyes with residual refractive error after implantation of ReSTOR® multifocal intraocular lenses.

Methods

We retrospectively reviewed the medical records of 10 eyes of 6 patients who had undergone cataract surgery with implantation of multifocal intraocular lenses. Photorefractive keratectomy (PRK) (5 eyes) and laser-assisted in situ keratomileusis (LASIK) (5 eyes) was performed on 10 eyes with residual refractive error.

Results

After cataract surgery and before laser surgery, the mean spherical equivalent (SE) was -0.34 ± 0.89 D and the mean astigmatism was 2.08 ± 0.55 D. Six months after laser surgery, the mean SE was -0.33 ± 0.30 D (p = 0.354) and the mean astigmatism was 0.23 ± 0.28 D. The changes in astigmatism between paired preoperative and postoperative values were statistically significant (p < 0.0001). At 6 months after surgery, uncorrected distance visual acuity significantly improved to 0.11 ± 0.10 (log MAR) (p < 0.0001) There were no significant changes in the best corrected distance visual acuity and uncorrected near visual acuity (p = 0.073, p = 0.100).

Conclusions

On the basis of predictability and stability, excimer laser surgery appears to be a clinically useful procedure to correct residual refractive error after implantation of ReSTOR® multifocal intraocular lenses.

Keywords: Astigmatism, LASIK, Multifocal intraocular lens, PRK, ReSTOR®

Figures and Tables

Figure 1
Spherical equivalent refraction and cylindrical refraction over 6 months after excimer laser surgery to correct residual refractive error. The changes in astigmatism were statistically significant between paired preoperative and postoperative values (*p < 0.05).
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Figure 2
Time course of uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA) at distance and UCVA at near for 10 eyes with excimer laser surgery. UCVA at distance improved at 1 week after surgery and were stable until 6 months after surgery (*p < 0.05).
jkos-53-1742-g002
Figure 3
Predictability of excimer laser surgery for spherical equivalent refraction (SE) and cylinder refraction (C). (A) Predictability of excimer laser surgery for spherical equivalent refraction (SE). (B) Predictability of excimer laser surgery for cylinder refraction (C). After 6 months after surgery, 8 eyes (80%) had a spherical equivalent refraction within ±0.25 D of emmetropia, 1 eyes (10%) were within ±0.25 to 0.50 D of emmetropia and 1 eyes (10%) were within ±0.50 to 0.75 D emmetropia. Seven eyes (70%) had a cylinder refraction within ±0.25 D, 2 eyes (20%) were within ±0.25 to 0.50 D and 1 eyes (10%) were within ±0.50 to 0.75 D.
jkos-53-1742-g003
Figure 4
Stability of excimer laser surgery for spherical equivalent refraction (SE) and cylinder refraction (C). (A) Stability of excimer laser surgery for spherical equivalent refraction (SE). (B) Stability of excimer laser surgery for cylinder refraction (C). After 1 month, spherical equivalent refraction and cylinder refraction was stable.
jkos-53-1742-g004
Table 1
Demographic characteristics
jkos-53-1742-i001

UCVA = uncorrected visual acuity; BCVA = best-corrected visual acuity; D = diopters.

*Mean ± SD; †Range.

Table 2
Refractive and visual acuity data before cataract surgery, before and after excimer laser surgery in 10 eyes
jkos-53-1742-i002
Table 3
Refractive and visual acuity data before and after excimer laser surgery
jkos-53-1742-i003

Values are presented as mean ± SD.

*Statistically significant result (p < 0.05).

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