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First Author: M.Koncarevic CROATIA
Co Author(s): M. Bohac M. Anticic N. Gabric
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: To evaluate safety and refractive outcome after LASIK enhancement in patients with previous phakic IOL (pIOL) implantation for high ametropia.
University Eye Hospital Svjetlost, Zagreb, Croatia
Retrospective study on 11 eyes (8 patients) who underwent LASIK enhancement after phakic IOL implantation. Implantation took place 6-8 months after initial operation. We measured preoperative and postoperative uncorrected (UCVA) and best corrected (BCVA) visual acuity (Snellen lines), amount of high order aberrations, distance from pIOL to endothelium (Anterior Visante OCT, Zeiss) and endothelial cell density (ECD) loss immediately after the procedure. Follow up was one year.
Preoperative UCVA was 0,47 compared to postop 0,76, preop BCVA was 0,76 compared to 0.81 postoperative. Mean preoperative sphere was 0,97 (ranging from -0,25 to +2,75), mean preoperative cylinder was -1,48 (ranging from -5,25 to +1,77). Mean postoperative sphere was 0,076 (ranging from -0,50 to +0,50), mean cylinder was -0,41 (ranging from -1,50 to +1,25). Amount of high order aberrations measured at 5 mm pupil remained unchanged (preoperative trefoil 0,36ḟ0.12, coma 0,16ḟ0.02, spherical aberration 0,052ḟ0.04 and postoperative 0,32ḟ0.01, 0,12ḟ0.03, -0,02ḟ0.09 respectively). Mean ECD was 2571ḟ362 cell/mmĠ and remained unchanged 1 month after the surgery. Mean distance from pIOL to endothelium was 2,26ḟ21 ṁm.
LASIK after pIOL implantation is effective procedure. The main consideration is ECD loss during vacuum application, which could be safely applied if the distance between the pIOL and endothelium is more than 2mm. More eyes and longer follow up are needed to prove its long term safety.