Comparing Visual Outcomes of Light Adjustable Intraocular Lenses in Patients With and Without Prior History of Corneal Refractive Surgery

Abstract

Purpose: To assess visual outcomes of light adjustable intraocular lens (LAL; Calhoun Vision, Inc) implantation after cataract extraction in patients with a history of corneal refractive surgery. Methods: The records of patients who received LALs with and without a history of corneal refractive surgery were retrospectively reviewed. Data for 51 eyes (30 patients) with a history of corneal refractive surgery and 52 eyes (44 patients) without refractive surgery were analyzed. A total of 36 eyes of patients with and 43 eyes of patients without a history of corneal refractive surgery had 12-month follow-up data available. The primary outcomes evaluated were uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA). Results: At 12 months, 31% of eyes with a history of corneal refractive surgery had a UDVA of 20/20 or better and 97% of eyes were 20/40 or better. In contrast, 63% of patients with no history of corneal refractive surgery had 20/20 UDVA or better at 12 months and 100% were 20/40 or better. Of patients with a history of corneal refractive surgery, 55% and 83% of eyes at 12 months were within ±0.50 and ±1.00 diopters, respectively, of the target refraction compared to 89% and 96% of eyes without a history of corneal refractive surgery. Conclusions: LALs are a promising platform for achieving excellent visual outcomes following cataract surgery. Patients with a prior history of corneal refractive surgery can achieve excellent visual outcomes with the LAL. However, this study found that patients with a history of corneal refractive surgery demonstrated less predictable visual acuity outcomes when compared to patients without a history of corneal refractive surgery. [ J Refract Surg. 2023;39(5):311–318.]