Laser in Situ Keratomileusis for Residual Refractive Error After Multifocal IOL Implantation in Highly Hyperopic Patients
To analyze the refractive outcome and report the results of combining multifocal intraocular lens (MIOL) implantation and excimer corneal surgery to treat very high hyperopia.
Prospective non-controlled interventional case series. Ten eyes (5 female patients, mean age 31.08 ± 11.08 years) with very high hyperopia (spherical equivalent +8.51 ± 0.86 D) had been treated with serial MIOL implantations followed by laser in situ keratomileusis (LASIK) for residual hyperopia 6 weeks later. Uncorrected distance visual acuity (VA), uncorrected near VA, corrected distance VA, corrected near VA and manifest refraction were evaluated before all surgeries, after MIOL implantation and 1 month post-LASIK procedure.
There were no losses to follow-up. The mean spherical equivalent decreased to +2.05 ± 1.33 D after MIOL implantation and to -0.10 ± 0.58 D after the LASIK procedure. The LogMAR uncorrected distance VA improved by >6 lines, from a mean of 1.06 ± 0.17 to 0.46 ± 0.12 post-MIOL implantation and to 0.33 ± 0.22 after both surgeries. Although the LogMAR uncorrected near VA had increased by >30%, it averaged 0.8 ± 0.81 after lens implantation due to loss of accommodation and lack of proper refraction state. All eyes reached a LogMAR of 0 at 1 month postoperatively.
Bioptics of MIOL implantation followed 6 weeks later by a LASIK procedure for correction of very high hyperopia allowed treatment of the total refractive error and reduced patient dependence on spectacles.