OUTCOMES OF EXTENDED DEPTH-OF-FOCUS INTRAOCULAR LENS IMPLANTATION IN EYES WITH PREVIOUS CORNEAL REFRACTIVE SURGERY

To report outcomes of AcrySof IQ Vivity IOL implantation in eyes with previous corneal refractive surgery.

With corneal refractive surgery increasingly in popularity, more patients are now undergoing cataract surgery having had previous corneal refractive surgery. Intraocular lens (IOL) power calculations are less accurate in eyes that have undergone corneal refractive surgery due to difficulties in accurately determining corneal refractive power and there is a higher likelihood of refractive error. Extended depth-of-focus (EDOF) IOLs are a promising treatment option for presbyopia, providing an extended range of vision with good distance and intermediate vision and a similar side effect profile to a standard monofocal lens. As they have a certain tolerance for refractive errors, they may be preferable in post-laser surgery eyes. The AcrySof IQ Vivity (Alcon Inc., USA) is a recently introduced, novel, non-diffractive EDOF IOL.

A retrospective review of all patients with previous corneal refractive surgery who underwent cataract surgery with implantation of an AcrySof IQ Vivity IOL, performed by a single surgeon was carried out. Binocular and monocular uncorrected visual acuities (UCVA) and best-corrected visual acuities (BCVA) were assessed at distance (6m) and near (40cm) post-operatively at 1 month. Refractive outcome, post-operative complications, and presence of dysphotopsias were also noted.

Seventeen eyes with included, comprising 9 patients with a median age of 64 (58-71). Eight patients had delayed sequential bilateral cataract surgery. Fifteen eyes had had myopic LASIK and 2 eyes hyperopic LASIK. Ten eyes (58.8%) received a toric lens with a mean pre-operative delta K of -1.43D. Post-operative binocular UDVA was 0.01 ± 0.05 logMAR (range: -0.06 to 0.1) and binocular UNVA was 0.32 ± 0.15 logMAR (range: 0.10 to 0.58). Post-operative monocular UDVA was 0.10 ± 0.18 logMAR (range: -0.10 to 0.50) and monocular UNVA was 0.42 ± 0.20 logMAR (range: 0.10 to 0.66). Barrett True-K formula was used for all eyes. Refractive mean absolute error was -0.31D, with 88.2% of patients within 1D and 76.5% within 0.5D. No intra- or post-operative complications occurred and there were no reports of dysphotopsias.

The AcrySof IQ Vivity IOL performed well with Barrett True-K formula in eyes with previous corneal refractive surgery and was well tolerated.