Using Small Aperture Optics to Treat Post-Corneal Refractive Surgery Patients with Cataracts | ASCRS
Presentation
Using Small Aperture Optics to Treat Post-Corneal Refractive Surgery Patients with Cataracts
May 2020
Meeting: 2020 Virtual Annual Meeting
Session: SPS-110 Post Refractive Surgery - IOL Calculations
Author: Roger Zaldivar, MD
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Purpose
To evaluate visual performance and ease of use of a small aperture IOL in cataract patients with a history of corneal refractive surgery

Methods
Retrospective analysis of 10 patients presenting for cataract surgery with a history of prior corneal refractive surgery. Preoperative total high order aberrations were 0.5 um + 1.1 um. Prior corneal refractive surgery includes hyperopic and myopic laser vision correction (n=10). Patients were implanted either contralaterally with an IC-8 IOL (AcuFocus) in one eye and a monofocal IOL in their fellow eye. IC-8 IOL eyes were targeted for -0.75 D and their fellow monofocal eyes targeted for plano. Uncorrected visual acuity, total corneal higher order aberrations, and manifest refractive surgical equivalent (MRSE) were evaluated.

Results
Pre-op Sph Eq changed from -0,65 SD ±3,32 to -0,43 SD ± 0,50 after one month of the surgical procedure. The mean preop UCVA was 0,66 improving to 0,09 at 3 months. MEDIAN 0,71 (1day) 0,00 (3 months). 7 patients gained at least 1 line after 3 months of the surgery. MEAN preop BCVA was 0,22 improving to 0,05 at third month. SD preop 0,18 and 3 months postop 0,10. Preoperatively the mean near UCVA was 0,67 and improved to 0,15 three months after surgery. Patients increased their functional distances at near and intermediate. There was an improvement of night driving symptomatology.

Conclusion
The combination of a small aperture IOL and a monofocal IOL effectively compensated corneal higher order aberrations in patients with prior LASIK procedure. Patients increased their functional distances at near and intermediate. There was an improvement of night driving symptomatology. 7 patients gained at least 1 line after 3 months of the surgery
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This presentation is from the session "SPS-110 Post Refractive Surgery - IOL Calculations" from the 2020 ASCRS Virtual Annual Meeting held on May 16-17, 2020.

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