Combined Correction of Axial Hyperopia and Astigmatism Using the Light Adjustable Intraocular Lens

Abstract

To determine whether residual spherical and cylindrical errors could be corrected postoperatively using spatially profiled UV light irradiation in patients with axial hyperopia undergoing cataract surgery and implantation of a light adjustable, silicone intraocular lens (LAL). We conducted a prospective, nonrandomized clinical trial. The LALs were implanted in eyes with axial lengths <22.20 mm and were treated with a spatial intensity profile delivered by a digital light delivery device to induce a targeted spherical and cylindrical refractive change postoperatively. Once the desired correction was achieved, the LAL was treated again to lock-in the lens power. We studied 15 eyes of 15 patients with axial hyperopia. The manifest refraction, uncorrected visual acuity (UCVA), and best spectacle-corrected visual acuity (BCVA) were determined with follow-up time of 12 months to determine the achieved refractive corrections and their stability. We measured UCVA, BCVA, achieved versus targeted refractive outcome, and refractive stability with a follow-up time of 12 months. Of 15 eyes, 14 (93%) achieved ± 0.5 diopters (D), and 10 (67%) were within ± 0.25 D of the targeted refractive adjustment up to 12 months postoperative follow-up. Only 1 treated eye showed a change of 0.38 D in manifest spherical equivalent refraction, the remaining 14 eyes showed <0.25 D change between 1 month post lock-in, and at the 3-, 6-, and 12-month postoperative visits. The light-adjustable lens is a promising technology with the potential to reduce the rate of postoperative refractive surprises up to 2 D of spherical and cylindrical errors after cataract surgery. Postoperative refractive errors were successfully corrected with precision and significant improvement in UCVA and without compromising BCVA using the light-adjustable intraocular lens technology. The data demonstrate the stability of the achieved refractive change after the adjustment and lock-in procedures.