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D. Mutyala, N. Menon, M. S. Macsai-Kaplan; Comparison Between Myopes and Hyperopes in the Effectivity of Refractive Enhancement Following Presbyopic Intraocular Lens Implantation. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4199.
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To evaluate the efficacy of laser in situ keratomileusis (LASIK) in correcting refractive error after cataract extraction (CE) and presbyopic intraocular lens (IOL) implantation. This study focuses on the similarities, differences and outcomes in treating residual myopia in comparison to residual hyperopia with LASIK.
A nonrandomized retrospective study of 22 eyes that underwent CE/IOL implantation of a Crystalens AT-45 (Eyeonics, Aliso Viejo, CA), ReZoom (Advanced Medical Optics, Santa Clara, California), or ReSTOR (Alcon Laboratories, Fort Worth, Texas) lens with subsequent LASIK enhancement surgery. All surgical procedures were performed by one surgeon (MM) from January 2004 to April 2008. In our study group, there were no surgical complications during the cataract surgery or LASIK procedure. Visual acuity data were converted to LogMAR for analysis. Statistical significance was defined as p≤0.05.
The mean interval between cataract surgery and LASIK was 12.36±8.76 months in myopes (n=15) and 12.50±6.85 months in hyperopes (n=7). The degree of refractive error was slightly greater in myopic eyes than hyperopic eyes: pre-LASIK absolute spherical equivalent of the myopic eyes was 1.20±0.85 vs. hyperopic eyes was 1.14±0.79 (p= 0.87). The pre-LASIK uncorrected distance visual acuity (UCDVA) of the myopic group (20/70) was found to be worse than the hyperopic group (20/40) (p = 0.07). The post-LASIK spherical equivalents were statistically significantly better than pre-LASIK spherical equivalents (S.E.) in both of the groups. In the myopic group, the pre-LASIK S.E. was -1.20±0.85 vs. post- LASIK S.E. was 0.03±0.59 (p<0.0001). In the hyperopic group: pre-LASIK S.E. was 1.14±0.79 vs. post-LASIK S.E. was 0.13±0.23 (p=0.02). Additionally, the post-LASIK UCDVA was noted to be similar between the two groups (~20/30; p = 0.87).
LASIK after presbyopic IOL implantation appears to be equally effective in treating residual myopia and hyperopia. In our study group, residual myopia resulted in worse distance visual acuity after cataract surgery, but had equivalent outcomes to the residual hyperopes after LASIK surgery. Since the advent of accomodating and multifocal IOLs, their use has become widespread in the ophthalmic community and learning more about the successes and failures of LASIK to treat residual ametropia is of value.
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