TOP STORIES 8/10/2010
LASIK results unpredictable after multifocal implantation, study says
J Refract Surg. 2010;26(8):569-577.
LASIK following cataract surgery and implantation of either a monofocal or a multifocal lens is effective in improving visual outcome, although predictability of the final result may be problematic after multifocal implantation in patients with hyperopia.
In a retrospective analysis of 100 consecutive patients with residual refractive error, 50 patients were implanted with a monofocal IOL and 50 patients received a multifocal IOL after cataract surgery; LASIK was then performed in both groups. Uncorrected distance visual acuity improved from 0.40 logMAR at baseline to 0.15 logMAR 6 months after LASIK in the multifocal group, and from 0.49 logMAR to 0.14 logMAR in the monofocal group (P <.01).
Change in cylinder (–0.98 D to –0.30 D multifocal; –1.43 D to –0.52 D monofocal), defocus equivalent (1.59 D to 0.68 D multifocal; 1.96 D to 0.57 D monofocal) and corrected distance visual acuity (0.08 logMAR to 0.05 logMAR multifocal; 0.15 logMAR to 0.12 logMAR monofocal) were all statistically significant 6 months after LASIK treatment.
A greater percentage of patients in the monofocal group had a spherical equivalent within ±0.50 D compared with patients in the multifocal group (84% vs. 70%), although the difference only bordered statistical significance.
However, "a worse predictability was found for those eyes implanted with a multifocal IOL that underwent a hyperopic LASIK refinement, with 62.5% of eyes with a [spherical equivalent] within ±0.50 D (multifocal myopia 83.33% vs. monofocal hyperopia 85.71% vs. monofocal myopia 82.76%)," the study authors wrote.