Outcomes of excimer laser enhancements in pseudophakic patients with multifocal intraocular lens

Steven C Schallhorn,^1–3 Jan A Venter,² David Teenan,² Julie M Schallhorn,³ Keith A Hettinger,² Stephen J Hannan,² Martina Pelouskova<sup>2

1</sup>Department of Ophthalmology, University of California, San Francisco, CA, USA; ²Optical Express, Glasgow, UK; ³Department of Ophthalmology, University of Southern California, Los Angeles, CA, USA

Purpose: The aim of this study was to assess visual and refractive outcomes of laser vision correction (LVC) to correct residual refraction after multifocal intraocular lens (IOL) implantation.
Patients and methods: In this retrospective study, 782 eyes that underwent LVC to correct unintended ametropia after multifocal IOL implantation were evaluated. Of all multifocal lenses implanted during primary procedure, 98.7% were refractive and 1.3% had a diffractive design. All eyes were treated with VISX STAR S4 IR excimer laser using a convectional ablation profile. Refractive outcomes, visual acuities, patient satisfaction, and quality of life were evaluated at the last available visit.
Results: The mean time between enhancement and last visit was 6.3±4.4 months. Manifest spherical equivalent changed from -0.02±0.83 D (-3.38 D to +2.25 D) pre-enhancement to 0.00±0.34 D (-1.38 D to +1.25 D) post-enhancement. At the last follow-up, the percentage of eyes within 0.50 D and 1.00 D of emmetropia was 90.4% and 99.5%, respectively. Of all eyes, 74.9% achieved monocular uncorrected distance visual acuity 20/20 or better. The mean corrected distance visual acuity remained the same before (-0.04±0.06 logMAR [logarithm of the minimum angle of resolution]) and after LVC procedure (-0.04±0.07 logMAR; P=0.70). There was a slight improvement in visual phenomena (starburst, halo, glare, ghosting/double vision) following the enhancement. No sight-threatening complications related to LVC occurred in this study.
Conclusion: LVC in pseudophakic patients with multifocal IOL was safe, effective, and predictable in a large cohort of patients.

Keywords: excimer laser enhancements, pseudophakic patients, multifocal IOL

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