June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Cataract surgery in challenging post refractive surgery scenarios.
Author Affiliations & Notes
  • Jorge E Valdez
    Instituto Tecnologico y de Estudios Superiores de Monterrey, Monterrey, Nuevo Leon, Mexico
  • Sofia Padilla-Alanís
    Instituto Tecnologico y de Estudios Superiores de Monterrey, Monterrey, Nuevo Leon, Mexico
  • Gustavo Ortiz Morales
    Instituto Tecnologico y de Estudios Superiores de Monterrey, Monterrey, Nuevo Leon, Mexico
  • Manuel Emiliano Quiroga-Garza
    Instituto Tecnologico y de Estudios Superiores de Monterrey, Monterrey, Nuevo Leon, Mexico
  • Daniel Bastan-Fabian
    Instituto Tecnologico y de Estudios Superiores de Monterrey, Monterrey, Nuevo Leon, Mexico
  • Manuel Antonio Salinas-Lugo
    Instituto Tecnologico y de Estudios Superiores de Monterrey, Monterrey, Nuevo Leon, Mexico
  • Jesus Enrique Arreola
    Instituto Tecnologico y de Estudios Superiores de Monterrey, Monterrey, Nuevo Leon, Mexico
  • Jose Alberto Nava-Garcia
    Instituto Tecnologico y de Estudios Superiores de Monterrey, Monterrey, Nuevo Leon, Mexico
  • Footnotes
    Commercial Relationships   Jorge Valdez None; Sofia Padilla-Alanís None; Gustavo Ortiz Morales None; Manuel Quiroga-Garza None; Daniel Bastan-Fabian None; Manuel Salinas-Lugo None; Jesus Arreola None; Jose Nava-Garcia None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 2886 – F0023. doi:
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    • Get Citation

      Jorge E Valdez, Sofia Padilla-Alanís, Gustavo Ortiz Morales, Manuel Emiliano Quiroga-Garza, Daniel Bastan-Fabian, Manuel Antonio Salinas-Lugo, Jesus Enrique Arreola, Jose Alberto Nava-Garcia; Cataract surgery in challenging post refractive surgery scenarios.. Invest. Ophthalmol. Vis. Sci. 2022;63(7):2886 – F0023.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To describe the refractive management, visual outcomes and patient satisfaction with refractive cataract surgery in challenging cases.

Methods : Retrospective chart review of selected cases. Throughout decision-making of refractive options after an exhaustive ophthalmological evaluation including IOL selection, aberrometry and surgical options was performed in agreement with all patients.

Results : Five challenging scenarios are reported with their management of refractive error. Case 1 presents a 54 year-old male with a history of LASIK surgery and clear lens, looking for refractive management. Multifocal IOLs were implanted in both eyes achieving UCVA of 20/20 in both eyes and UNVA of J1. Case 2 is a 72 year-old female with a history of LASIK surgery with a central island in the left eye presenting with bilateral cataract. Cataract surgery was performed with multifocal IOL in the right eye and monofocal IOL in the left eye, achieving a 20/20 uncorrected visual acuity (UCVA) and uncorrected near vision acuity (UNVA) of Jaeger (J) 1. Case 3 is a 59 year-old female with a history of RK presenting with bilateral cataract. Cataract surgery was performed with bilateral multifocal IOL implantation, achieving 20/20 UCVA in both eyes and UNVA of J3. Case 4 presents a 65-year-old female with a history of radial keratotomy (RK) with clear lens looking for refractive treatment. Right cornea was highly aberrated so monofocal IOL was implanted and a multifocal toric IOL in the left eye, achieving UCVA 20/20 in the right eye and 20/25 in the left eye, with a UNVA of J1.
Case 5 presents a 53-year-old male with a history of post-LASIK ectasia in the right eye, treated with penetrating keratoplasty (PKP) in which residual astigmatism was treated with LASIK plus enhancement 10 years later. The patient was seeking refractive management so a toric IOL was implanted, achieving a UCVA of 20/50.

Conclusions : Past history of refractive surgery and/or corneal disease makes for complex decision-making during the assessment for cataract surgery. Although challenging, the armamentarium of refractive options allows for excellent visual outcomes with great patient satisfaction.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

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