Wavefront-Guided PRK for Refractive Error Following Cataract Extraction With Aspheric IOL Implantation

Friday, April 25, 2014
KIOSKS (Boston Convention and Exhibition Center)
Lauren M. Imbornoni, University of Arizona College of Medicine, Tucson, AZ, USA
James T. Schwiegerling, PhD, University of Arizona, Tucson, AZ, USA
Brian A. Hunter, MD, University of Arizona Dept Ophthalmlogy, Tucson, AZ, USA
Robert Snyder, MD, PhD, University of Arizona, Tucson, AZ, USA

Narrative Responses:

Purpose
To describe the use of wavefront-guided photorefractive keratectomy (WFG-PRK) to correct refractive error and reduce higher order aberrations (HOA) in post-cataract surgery patients with collamer aspheric intraocular lenses (IOL).

Methods
This is a retrospective review of 8 eyes of 5 patients who underwent WFG-PRK with iris registration to correct residual refractive error following cataract extraction with implantation of CC4204A nanoFLEX collamer aspheric IOL (STAAR Surgical Company, Monrovia, CA). All procedures were performed by a single surgeon at one institution over the last two years. Visual acuity, manifest refraction and wavefront error were determined pre- and 1-11 months postoperatively.

Results
Uncorrected visual acuity (UCVA) improved in all eyes with mean improvement of 0.33±0.16 (range 0.10–0.60) logMAR. Mean pre-operative UCVA was 0.35±0.18 (range 0.10–0.70) logMAR and mean post-operative UCVA was 0.03±0.04 (range 0.00–0.10) logMAR. Best corrected visual acuity (BCVA) improved or remained 20/20 in all eyes. Mean pre-operative BCVA was 0.11±0.09 (range 0.00–0.30) logMAR and mean post-operative BCVA was 0.01±0.03 (range 0.00–0.10) logMAR. Mean HOAs measured by RMS error decreased. Mean pre-operative HOA measured by RMS error was 1.30±0.17 (range 1.04–1.5) and mean post-operative HOA measured by RMS error was 1.09±0.65 (range 0.51–2.19).

Conclusion
WFG-PRK is a safe and effective method to correct residual refractive error in post-cataract surgery patients. We obtained high quality wavescans through the collamer aspheric IOLs. The ability to obtain wavescans and perform WFG-PRK retreatment may be a consideration in IOL selection for patients where IOL calculation is difficult.