Laser enhancement after IOL implantation effective, but not for all patients

NEW YORK — Postoperative laser vision correction can improve refractive outcomes in patients implanted with presbyopic IOLs, according to a presenter here. However, one study showed that at 1 month postop, nearly one-third of patients still had not achieved emmetropia after one laser enhancement.

"Laser vision correction will provide an opportunity to deliver the final refractive results in astigmatic laser refractive correction," Guy M. Kezirian, MD, said at OSN New York 2009. It may not work in all eyes, but "it will in most," he said.

Dr. Kezirian presented data from three surgeons who implanted presbyopic IOLs and also routinely performed laser vision correction at 3 months for residual refractive error using the IntraLase (Abbott Medical Optics) and Allegretto Wave Eye-Q (Alcon). Refractive outcomes were analyzed 1 to 3 months after the procedure.

A total of 143 eyes were implanted with a multifocal or accommodating IOL: 26 eyes with the AcrySof ReSTOR SA60D3 (Alcon); 30 eyes with the ReZoom (AMO); 51 eyes with the Crystalens Five-O (Bausch & Lomb); and 36 eyes with the Crystalens HD (Bausch & Lomb). Incidence of enhancements varied among surgeons and among the type of lens used.

Of all patients, 49% had spherical equivalent within ±0.25 D of targeted correction after laser enhancement. Mean post enhancement refractive error was –0.16 D for the AcrySof ReSTOR SA60D3, –0.10 D for the ReZoom, –0.05 D for the Crystalens Five-O and –0.15 D for the Crystalens HD.

At 1 month after enhancement, 73.5% achieved ±0.50 D spherical equivalent; 83.3% had 0.50 D of cylinder or less; and 69.6% achieved emmetropia (±0.50 D spherical equivalent with 0.50 D of cylinder or less). However, 30.4% were not emmetropic, suggesting that additional procedures may be needed in some eyes to achieve target results.

OSN New York 2010 will be held November 19-21, 2010 at the Sheraton New York Hotel & Towers in New York City. Learn more at OSNNY.com.