LASIK Outcomes Following Multifocal and Monofocal Intraocular Lens Implantation

Abstract

To evaluate the efficacy, predictability, and safety of LASIK to correct residual refractive error following cataract surgery using multifocal and monofocal intraocular lenses (IOL). Included in this retrospective, comparative study were 100 consecutive eyes with residual refractive error that had undergone cataract surgery with monofocal or multifocal IOL implantation. Two groups were studied according to the implanted IOL--multifocal group (50 eyes, mean age 57.8 +/- 9.9 years) and monofocal group (50 eyes, mean age 51.0 +/- 10.0 years). In all cases, LASLK was performed using the SCHWIND ESIRIS excimer laser. A statistically significant improvement was observed in uncorrected distance (P < .01) and corrected distance (P < .01) visual acuity at 6 months postoperatively in both groups. A statistically significant reduction was also observed in defocus equivalent and cylinder (P < .01) postoperatively. No statistically significant differences in the percentage of eyes losing lines of corrected distance visual acuity were found between groups (14% multifocal vs 4% monofocal, P = .40). When comparing eyes undergoing hyperopic LASIK in each group, a difference in the limit of statistical significance was found in the percentage of eyes with a spherical equivalent refraction within +/- 0.50 diopters (70% multifocal vs 84% monofocal, P = .06). No significant differences in predictability were found between multifocal and monofocal myopic subgroups (P = .25). Laser in situ keratomileusis refinement after cataract surgery with monofocal IOL implantation provides a more accurate refractive outcome than after multifocal IOL implantation. Predictability of LASIK correction is limited in hyperopic eyes implanted with multifocal IOLs.