How To Manage Dissatisfied Patients After Cataract Surgery?

we aimed to investigate the improvement in visual acuity and patient satisfaction after small-incision lenticule extraction (SMILE) in pseudophakic (trifocal intraocular lens, IOL) patients with residual myopic refraction after cataract surgery

Eye Hospital , Pristina, Kosovo

3 months ago Cataract surgery with ZEISS AT LISA tri 839MP IOL implantation in both eyes. The patient, who had a myopic residual refraction problem, was using glasses to see distance. The right cornea is clear, CCT,550 μm and UDVA,0.2, CDVA,1.0 to -2.25 diopters and to:16 mm Hg, UNVA, J 2. The left cornea is transparent, CCT,554 μm and UDVA,0.1, CDVA,1.0 -2.50 with diopters:16 mmHg, UNVA, J2.Smile surgery was performed on both eyes of the patient. 2 mm incision on the right cornea, intrastromal pocket with a diameter of 7.60 mm, optical zone 6.60 mm, -2.25 diopter lenticule extraction. 2 mm incision on the left cornea, and 7.60 diameter Intrastromal pockets were prepared and -2.50 diopter lenticule extraction was performed.

Results:

No complications were observed in the patient, the cornea was transparent, right and left UDVA, 1.0. We benefited from this feature of the trifocal lens and increased the distance and intermediate vision ratio without compromising the comfort of near vision. 

In addition, since the axial lengths of the patients were hyperopic, SMILE surgery was performed without drastically increasing the Q value and without drastically decreasing the total RMS.

This case demonstrates two important concepts, 

i.e., success was achieved by following the path without excessively increasing the Q value or excessively reducing the total RMS. 

The SMILE technique is a safe and effective treatment modality for pseudophakic myopic fractures to improve the visual outcomes and satisfaction of patients after cataract surgery.

Clinicaltrials.gov (NCT04693663)