Refractive correction with multifocal intraocular lenses after radial keratotomy.

PURPOSE

To assess visual and refractive results of multifocal intraocular lens (IOLs) implantation for refractive correction after radial keratotomy (RK).

METHODS

In a retrospective non-comparative interventional case series, we analyzed the outcomes of multifocal IOL implantation performed in the context of cataract or refractive lens exchange surgery following RK. A total of 17 eyes from nine patients were included in the study. IOL power calculation was done using the Double-K formula. Refractive error was used to assess predictability, and distance-corrected visual acuity (DCVA) and uncorrected distance visual acuity (UDVA) values were used to assess the surgical procedure's efficacy and safety. Distance-corrected near visual acuity (DCNVA) was also determined.

RESULTS

Phacoemulsification and multifocal IOL implantation was successful in all cases, with neither complications nor adverse events. At 6 months postoperatively, monocular UDVA, DCVA, and DCNVA were 0.51 ± 0.39, 0.20 ± 0.30, and 0.11 ± 0.11, respectively (logMAR scale). More specifically, 35.29% of the eyes had DCVA ≥20/20 and 52.94% showed DCVA ≥20/25. Regarding pre- vs. post-operative changes, 52.94% had lost one line of DCVA, 23.53% showed no changes, 11.76% had gained one line of DCVA, 5.88% had gained two lines, and 5.88% had gained three or more lines. The efficacy and safety indexes were 0.56 and 0.98, respectively. As for near vision surgical outcomes, 29.41% of the eyes had DCNVA ≥20/20 and 64.71% had DCNVA ≥20/25. As for surgical accuracy, 29% of the eyes were within ±0.50 D of the target refraction, whereas 65% were within ±1.00 D.

CONCLUSIONS

Multifocal IOL implantation following radial keratotomy (RK) does not result in good distance visual performance, at least after 6 months of follow-up. Thus, this surgical approach has to be considered with only limited expectations.