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Session Title: Intraocular correction of presbyopia : multifocal IOLs, Monovision
Session Date/Time: Tuesday 08/10/2013 | 14:00-16:00
Paper Time: 15:42
Venue: Elicium 1 (First Floor)
First Author: : J.Alfonso SPAIN
Co Author(s): : M. Naveiras R. Montés-Micó L. Fernįndez-Vega
To evaluate the visual outcomes, safety and predictability of implantation of a diffractive lens with negative sphericity in patients with cataract that had previously undergone a myopic laser in situ keratomileusis (LASIK) or photo-refractive keratectomy (PRK).
Instituto Oftalmológico Fernįndez-Vega, Oviedo, Spain
Prospective study of 22 eyes from 16 patients, 5 males and eleven females, with a mean age of 54.13 years that had undergone LASIK for the correction of myopia and that had developed cataracts over time. LASIK had been performed using a VISX Star S3 (AMO, Abbott Laboratories Inc., Illinois, USA) excimer laser platform. All the cataract surgeries were peformed by the same surgeon (JFA). The intraocular lens (IOL) used for the cataract surgery was the Tecnis One (AMO, Abbott Laboratories Inc., Illinois, USA) and the power of the IOL was calculated in all cases following the double-K method of Aramberri. Surgery was made through an incision placed at the steepest meridian of the cornea; after the phacoemulsification a capsular tension ring of rectangular design (ACS, AJL Ophthalmic, Alava, Spain) followed by the Tecnis lens were implanted. The parameters evaluated were manifest refraction, keratometry, visual acuity, pachymetry, axial length and pupil size. All these data was recorded preoperatively and xx months after surgery.
The mean preop sphere was -2.50 ± 3.27 diopters (D) which was reduced to 0.19 ± 0.53 D. The mean refractive cylinder was also reduced from -0.58 ± 0.52 D. to -0.26 ± 0.34. There was no significative variation in the keratometry readings between the preop and postop values. The distance corrected visual acuity improved slighty from 0.74 ± 0.25 (decimal) to 0.86 ± 0.15. Safety of the procedure was excellent, with 95% of eyes reaching equal or more distance visión than before surgery. The predictability was also excellent, with 73% of eyes between ±0.50 D. and 91% of eyes between ±1.00 D. Only two eyes (9%) needed a laser enhancement.
The implantation of a diffractive lens with negative sphericity in cases of previous LASIK is a safe and precitable procedure. The combination of this lens with the calculation by the Double-K method and a premium surgery provided excellent visual outcomes.
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