Author:
Cobo-Soriano Rosario,Rodríguez-Gutiérrez Beatriz,Bilbao-Calabuig Rafael,Tejerina Víctor,Fernández-Corrochano Alba,Druchkiv Vasyl,Beltrán Jaime
Abstract
PURPOSE:
To analyze corneal aberrations and factors affecting visual outcomes after implantation of a trifocal intraocular lens (IOL) in eyes previously treated with laser corneal refractive surgery.
METHODS:
This retrospective case series included 222 consecutive eyes implanted with the trifocal FineVision Micro-F IOL (PhysIOL) after laser corneal refractive surgery. The series was divided into two groups according to safety outcomes after lensectomy: eyes with loss of one or more lines of corrected distance visual acuity (CDVA) [n = 59, 26.5%]) (failed eyes group) and eyes with no loss or gain in CDVA lines (n = 163, 73.4%]) (successful eyes group). Distribution of tomographic corneal aberrations (spherical aberration [Z
4
0
], comatic and root mean square of higher order aberrations [RMS-HOA]), laser corneal refractive surgery error, kappa angle, and CDVA after laser corneal refractive surgery were compared among both groups.
RESULTS:
Mean CDVA after lensectomy was 0.15 ± 0.07 logMAR (range: 0.05 to 0.30 logMAR) versus 0.03 ± 0.04 logMAR (range: 0.00 to 0.15 logMAR) in the failed and successful eyes groups, respectively (
P
< .001). Comparison of both groups showed that failed eyes had a statistically significantly higher grade of hyperopic laser corneal refractive surgery than successful eyes measured as mean sphere (+0.71 ± 3.10 diopters [D] [range: −7.75 to +6.00 D] vs −0.46 ± 3.70 D [range: −10.75 to +6.00 D],
P
< .01), spherical equivalent (+0.27 ± 3.10 D [range: −8.00 to +5.50 D] vs −0.97 ± 3.60 D [range: −12.50 to +4.90 D],
P
< .05), and percentage of hyperopic laser corneal refractive surgery (64% vs 43.5%,
P
< .05). Corneal aberration analysis showed that mean Z
4
0
values were significantly more negative in the failed eyes group than in the successful eyes group (+0.07 ± 0.40 mm [range: −0.82 to +0.65 mm] vs +0.18 ± 0.37 mm [range: −0.79 to +0.87 mm],
P
< .05). Laser corneal refractive surgery cylinder was distributed homogeneously between both groups, as well as coma and RMS-HOA, kappa angle, and CDVA after laser corneal refractive surgery that were not statistically significant.
CONCLUSIONS:
Surgeons should consider tomographic corneal spherical aberration after implantation of a trifocal IOL in eyes after keratorefractive surgery, particularly in eyes previously treated with hyperopic laser corneal refractive surgery, to prevent loss of lines of visual acuity after lensectomy.
[
J Refract Surg
. 2022:38(4):222–228.]
Cited by
7 articles.
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