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

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 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 (μm), 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. J Korean Ophthalmol Soc 2014;55(12):1779-1786