Laser vision correction can reduce refractive error after cataract surgery, multifocal IOL implantation

CHICAGO — Laser vision correction is effective in reducing residual refractive error after cataract surgery and multifocal IOL implantation, according to a physician here.

"In our practice, with premium IOLs, if a patient has 1.5 D or less of astigmatism, we do a limbal relaxing incision," Kerry D. Solomon, MD, said at Cornea Day 2008, which preceded the American Society of Cataract and Refractive Surgery annual meeting.

"I have had a reasonable amount of success with patients with lower amounts of astigmatism. For patients who have 1.5 D or more of astigmatism, those patients, in my practice, we treat with laser vision correction."

In planned cases, the surgeon can cut a flap in advance by using either a femtosecond laser or a mechanical microkeratome 1 or 2 weeks before the patient's cataract or lens exchange surgery.

Dr. Solomon said he prefers to use the IntraLase femtosecond laser (Advanced Medical Optics) because of its low incidence of epithelial abrasions.

Creating the flaps preoperatively gives the surgeon an advantage: The surgery to correct the refractive error can take place weeks, rather than months, after the cataract surgery and multifocal IOL implantation.

Dr. Solomon and colleagues conducted a retrospective chart review evaluating visual outcomes and visual satisfaction of patients who underwent LASIK or PRK for residual refractive error after uneventful cataract surgery and multifocal lens implantation.

They also conducted a telephone survey.

They evaluated 19 eyes of 16 subjects.

"The vast majority of patients, after their laser vision enhancement, did have a better reduction of the use of spectacle use, especially as it related to near vision," Dr. Solomon said. "Patient satisfaction overall was actually quite good before their laser vision enhancement and even better after their touch-up."