Trifocal intraocular lens implantation in eyes with previous corneal refractive surgery for myopia and hyperopia.
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2021
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Journal of Cataract and Refractive Surgery
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Abstract
Purpose: To evaluate the visual and refractive outcomes of trifocal
intraocular lens (IOL) implantation in eyes previously treated with
myopic and hyperopic corneal refractive laser surgery.
Setting: Clinica Baviera-AIER-Eye group, Spain.
Design: Retrospective comparative case series.
Methods: The series was divided into 2 groups according to the
type of corneal laser refraction (myopic and hyperopic). The main
visual and refractive outcome measures included corrected
distance visual acuity (CDVA) and uncorrected distance and
near visual acuity, safety, efficacy, and predictability. The secondary
outcome measures were percentage of enhancement
and Nd:YAG capsulotomy and influence of prelaser magnitude
of myopia and hyperopia on the outcome of trifocal IOL
implantation.
Results: The sample comprised 868 eyes (543 patients): myopic,
n = 319 eyes (36.7%); and hyperopic, n = 549 eyes (63.2%). Three
months postoperatively, visual outcomes were poorer in the hyperopic
group than those in the myopic group for mean CDVA (0.06 ± 0.05 vs
0.04 ± 0.04, P < .01) and safety (21% vs 12% of CDVA line loss, P <
.05) outcomes. However, precision outcomes were worse in the
myopic group than those in the hyperopic group, with amean spherical
equivalent of 0.38 ± 0.3 vs 0.17 ± 0.3 (P < .01). Stratification by
magnitude of primary laser treatment revealed poorer visual and safety
results in the high hyperopia subgroup (>+3.0 diopters [D]) and poorer
precision in the high myopia subgroup (< 5.0 D).
Conclusions: Trifocal IOL implantation after photorefractive surgery
in eyes previously treated with myopic ablation achieved good
visual outcomes but less predictability in the high myopia subgroup.
However, eyes with a previous hyperopic corneal ablation achieved
excellent precision but worse visual and safety outcomes in the high
hyperopia subgroup.