Visual And Refractive Outcomes Of An Edof Intraocular Lens In Post-Lasik Eyes Vs Non-Lasik Controls: A Real-World Retrospective Comparison
Published 2026 - 44th Congress of the ESCRS
Reference: POCAT375 | Type: Free paper | DOI: 10.82333/qwrf-xb49
Authors: Dr David Mingo Botín* 1 , Victor Tejerina 2 , Pablo Rabadán 2 , Dr Félix González 3 , Dr Santiago Delgado 4 , Cristina Peláez 5
1Department of Cataract and Refractive Surgery ,IMO Madrid - Grupo Miranza,Madrid,Spain;Ophthalmology,Hospital Universitario Ramón y Cajal,Madrid,Spain, 2Department of Cataract and Refractive Surgery ,IMO Madrid - Grupo Miranza,Madrid,Spain, 3Department of Cataract and Refractive Surgery ,Miranza IOA,Madrid,Spain, 4Department of Cataract and Refractive Surgery ,Miranza Ophthalteam,Madrid,Spain, 5Department of Research and Development,Miranza,Madrid,Spain
Purpose
Extended depth-of-focus (EDOF) intraocular lenses (IOLs) provide an increased range of vision in unoperated eyes; however, evidence in post-LASIK corneas remains limited due to altered corneal curvature and higher-order aberrations. This study evaluates visual and refractive outcomes following implantation of a non-diffractive EDOF IOL (Tecnis PureSee) in post-LASIK eyes compared with non-LASIK controls in a real-world retrospective cohort.
Setting
Three affiliated private ophthalmology centers in Madrid, Spain (Miranza Group: Instituto de Microcirugía Ocular, Instituto de Oftalmología Avanzada, and Clínica Ophthalteam). All procedures were performed by experienced cataract surgeons using standardized biometric, calculation, and surgical protocols across centers.
Methods
Retrospective review of consecutive eyes undergoing phacoemulsification with Tecnis PureSee non-diffractive EDOF IOL implantation (2024–2025). Eyes were stratified into post-LASIK and virgin cornea groups. Preoperative assessment included demographics, manifest refraction, optical biometry, and corneal topography/aberrometry. IOL power calculation used Barrett Universal II (controls) and Barrett True-K (post-LASIK). At 1–3 months, uncorrected and corrected distance and near visual acuity (UDVA, CDVA, UNVA, CNVA), all in logMAR, manifest refraction, spherical equivalent (SE), and prediction error were recorded. Eyes with ocular comorbidity, intraoperative complications, or additional procedures were excluded.
Results
A total of 118 patients (118 eyes; one eye per patient) were included: 58 post-LASIK and 60 control eyes. Preoperatively, post-LASIK eyes showed flatter keratometry (p<0.001), longer axial length (p<0.001), and higher RMS HOAs (0.25±0.14 vs 0.19±0.11; p=0.001). Postoperative UDVA was 0.07±0.08 and CDVA 0.04±0.06 in the post-LASIK group versus 0.05±0.09 and 0.02±0.06 in controls (p=0.016 and 0.001, respectively). Postoperative UNVA was 0.16±0.10 and CNVA 0.02±0.05 in post-LASIK eyes versus 0.17±0.09 and 0.01±0.06 in controls (p>0.5). Prediction error within ±0.50 D occurred in 93.3% of post-LASIK eyes and 77.6% of controls, and within ±1.00 D in 100% and 98.3%, respectively (p=0.046). Mean postoperative SE did not differ significantly.
Conclusions
Implantation of a non-diffractive EDOF IOL in post-LASIK eyes achieved visual outcomes comparable to virgin corneas. Although statistically significant differences in distance visual acuity were observed, these were not clinically meaningful. Near visual performance was similar between groups. Refractive predictability was reduced in post-LASIK eyes, reflecting intrinsic limitations of IOL power calculation in altered corneas. Prospective controlled studies are warranted.