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