Abstract
Background
Laser-assisted in situ keratomileusis (LASIK) is widely used to correct refractive errors in myopia and astigmatism. The choice of presbyopia-correcting intraocular lenses (IOLs) for post-LASIK cataract surgery is a significant concern. However, few direct comparison studies exist between eyes with and without a history of LASIK. We analyzed the performance of extended depth of focus (EDOF) IOL implantation in these two groups.
Methods
This retrospective single-center study included patients with or without previous LASIK who underwent cataract surgery and EDOF Symfony IOL implantation, with \(\ge 1\) follow up. All patients underwent optical biometry using the IOLMaster (IOLMaster 500, Carl Zeiss). IOL power was calculated using the SRK/T formula for non-LASIK patients and the Haigis-L formula for LASIK patients. Uncorrected distance visual acuity (UDVA), uncorrected near visual acuity (UNVA), refraction, and corneal tomography were recorded. The prediction error was the absolute difference between the postoperative sphere and the target refraction. The right eyes of patients who met the inclusion criteria were selected for analysis.
Results
Among the 331 recruited eyes, 18 underwent previous LASIK. After 1:3 age/sex matching, 17 LASIK and 49 non-LASIK eyes from 66 patients were analyzed. No significant preoperative differences existed in target refraction, spherical equivalent, or best-corrected visual acuity. All surgical procedures were uneventful. Non-inferiority tests showed that LASIK exhibited non-inferiority to non-LASIK for predictive refraction error and UNVA. Age/sex matched regression analysis results suggested that there was no UDVA superiority between the two groups.
Conclusion
Previous LASIK had no discernible effect on the visual performance of presbyopia-correcting EDOF IOLs with respect to the absolute refractive error, UNVA, and UDVA. For further validation, larger-scale or multicenter studies are required to ensure the robustness and generalizability of our results in diverse clinical settings.
Trial registration
ClinicalTrials.gov, NCT06165796. Registered 4 December 2023 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT06165796