Chow Sharon S W, Chan Tommy C Y, Ng Alex L K, Kwok Alvin K H
Department of Ophthalmology, Grantham Hospital, Aberdeen, SAR, Hong Kong.
Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Shatin, SAR, Hong Kong.
Int Ophthalmol. 2019 May;39(5):1199-1204. doi: 10.1007/s10792-018-0908-0. Epub 2018 Mar 28.
Laser in situ keratomileusis (LASIK) is the most common refractive surgery in young patients, which aims at providing a clear distance vision without the use of spectacles. With time, these patients develop symptomatic cataract, which affects activities of daily living, and to improve visual acuity, intraocular lens (IOL) implantation can be considered. In post-myopic LASIK patients, to allow continuation of spectacle independence, the implantation of presbyopia-correcting IOLs is a suitable option. The purpose of this retrospective case series is to report the visual outcome and quality in post-myopic LASIK eyes after the implantation of AT LISA tri839MP IOL.
Twenty eyes of 13 patients with history of myopic LASIK within 20 years underwent phacoemulsification by one single surgeon. All eyes were implanted with AT LISA tri839PMP IOL, and their outcomes were evaluated at 6 months postoperation.
The mean postoperative uncorrected distance visual acuity (VA) is 0.28 ± 0.29, while the corrected distance VA is 0.06 ± 0.14. The mean postoperative uncorrected near VA is 0.02 ± 0.05, while the corrected near VA is 0.01 ± 0.02. The mean postoperative manifest refraction spherical equivalent (SE) is - 0.92 ± 0.76D. There is a statistically significant difference between the preoperative and postoperative refraction (p = 0.02), which shows a postoperative myopic shift. There is also a statistically significant difference between the mean targeted SE and postoperative manifest refraction SE (p = 0.00). Only one out of 20 eyes (5%) reported halo and glare symptoms. Ten out of 20 eyes (50%) are able to achieve spectacles independence.
In conclusion, in post-myopic LASIK eyes, AT LISA tri839MP provides a good visual outcome at both near and distance, but is more predictable at near than at distance. There is a myopic shift in the postoperative SE. Visual quality is satisfactory and has not been exacerbated. Most patients can remain to be spectacles free at all distances.
准分子原位角膜磨镶术（LASIK）是年轻患者中最常见的屈光手术，旨在无需佩戴眼镜即可提供清晰的远视力。随着时间的推移，这些患者会出现有症状的白内障，影响日常生活活动，为提高视力，可考虑植入人工晶状体（IOL）。在近视LASIK术后患者中，为了继续保持不依赖眼镜，植入可矫正老花眼的IOL是一个合适的选择。本回顾性病例系列的目的是报告植入AT LISA tri839MP IOL后近视LASIK术后眼的视觉结果和质量。
13例有20年内近视LASIK手术史的患者的20只眼由同一位外科医生进行了超声乳化手术。所有眼均植入了AT LISA tri839PMP IOL，并在术后6个月评估其结果。
术后平均未矫正远视力（VA）为0.28±0.29，而矫正远视力为0.06±0.14。术后平均未矫正近视力为0.02±0.05，而矫正近视力为0.01±0.02。术后平均显性验光球镜等效度（SE）为-0.92±0.76D。术前和术后验光之间存在统计学显著差异（p = 0.02），显示术后有近视漂移。平均目标SE与术后显性验光SE之间也存在统计学显著差异（p = 0.00）。20只眼中只有1只眼（5%）报告有光晕和眩光症状。20只眼中有10只眼（50%）能够实现不依赖眼镜。
总之，在近视LASIK术后眼中，AT LISA tri839MP在近视力和远视力方面均提供了良好的视觉结果，但在近视力方面比远视力更可预测。术后SE有近视漂移。视觉质量令人满意且未恶化。大多数患者在所有距离都可以不戴眼镜。
