Spectacle Independence after Cataract Extraction in Post-Radial Keratotomy Patients Using Hybrid Monovision with ReSTOR® Multifocal and TECNIS® Monofocal Intraocular Lenses

Gupta, Isha; Oakey, Zack; Ahmed, Faisal; Ambati, Balamurali K.

doi:10.1159/000363372

Cited by 8 publications

(5 citation statements)

References 7 publications

(10 reference statements)

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“…To our knowledge, there have been few case reports and no reviews investigating the use of multifocal lenses in patients with a history of RK. Two reports describe favorable patient satisfaction in 3 patients (5 total eyes) using a refractive-type multifocal IOL (Oculentis LS313-MF30; Soleko FIL611PVT),6,7 while a third describes 2 eyes of 2 patients that received a ReSTOR diffractive multifocal optic in the nondominant eye 8. While the aforementioned reports suggested acceptable levels of patient satisfaction and spectacle independence, there remains insufficient objective evidence supporting the routine use of advanced-optics IOLs in this patient population.…”

Section: Discussionmentioning

confidence: 99%

“…However, post-refractive patients may carry higher expectations and be motivated to reduce spectacle dependence after cataract surgery. To date, only 5 patient cases have been described regarding use of multifocal lenses in patients with prior RK (3 patients with refractive multifocal optic, 2 patients with diffractive multifocal optic),6–8 and no summative objective or subjective data are available. The intent of the current study is to report visual performance and subjective satisfaction in patients with prior RK that have undergone cataract surgery with implantation of an extended depth of focus (EDOF) IOL.…”

Section: Introductionmentioning

confidence: 99%

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<p>Extended depth of focus lens implantation after radial keratotomy</p>

Baartman¹,

Karpuk²,

Eichhorn³

et al. 2019

OPTH

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Purpose To identify the visual performance of radial keratotomy (RK) patients that have undergone cataract surgery with implantation of an extended depth of focus (EDOF) intraocular lens (IOL). Design Retrospective chart review with questionnaire. Methods Medical charts of patients with a history of RK that had undergone phacoemulsification with implantation of the Tecnis Symfony IOL (J&J Vision) were reviewed. Data collected included preoperative demographics, number of RK incisions, pupil size, and preoperative visual acuity and manifest refraction. Primary outcome measures of the study included postoperative uncorrected distance visual acuity (UCVA) and manifest refraction spherical equivalent (SE) at each follow-up visit. Secondary outcomes included results from a telephone questionnaire assessing visual performance and satisfaction. Results Twenty-four eyes of 12 patients were included. UCVA improved from an average Snellen equivalent 20/73 preoperatively to 20/33 at an average final follow-up of 6 months ( P =0.0011), while average manifest SE improved from +1.68 D to −0.18 D ( P <0.0001). At final follow-up, 15 of 24 eyes (62.5%) were at or within 0.5 D of target refraction, while 20 of 24 eyes (83.3%) were at or within 1.0 D. In total, 79% of eyes (19 of 24) had UCVA of 20/40 or better at distance. In the survey, 78% of patients reported satisfaction with their vision after surgery and 44% of patients reported being spectacle free for all tasks. Conclusions An EDOF lens implant can produce good visual outcomes and satisfaction in patients with a history of RK.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

<p>Extended depth of focus lens implantation after radial keratotomy</p>

Baartman¹,

Karpuk²,

Eichhorn³

et al. 2019

OPTH

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“…With regard to visual acuity correction in patients undergoing RK with hyperopic shift and presbyopia, a possible and well-tolerated solution is represented by the implantation of multifocal IOLs, as reported by Kim et al [ 3 ] and Gupta et al [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

Implantation of a Multifocal Toric Intraocular Lens after Radial Keratotomy and Cross-Linking with Hyperopia and Astigmatism Residues: A Case Report

Nuzzi¹,

Monteu²,

Tridico³

2017

Case Rep Ophthalmol

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Radial keratotomy is a refractive surgical technique, widely used in the 80s and early 90s to correct myopia and astigmatism, but now overcome by more recent laser techniques. Important consequences, often in patients with more than 45 years of age, are progressive hyperopic shift and/or an increase in corneal astigmatism, whose main cause seems to be an increase in the curvature radius of the central portion of the cornea. This seems to be due to radial keratotomy incisions – with the consequent need for cross-linking – intraocular pressure, and corneal biomechanical parameters. The authors propose phacoemulsification with a customized multifocal toric intraocular lens implantation to correct the induced shift and hyperopic astigmatism. A decent postoperative visual acuity was observed with good patient satisfaction. A specific protocol must be applied to optimize the correct diagnosis, presurgical evaluation and postsurgical outcomes that are to be maintained over time, without regressions.

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“…Recently, Tahzib et al 9 reported implantation of an Artisan toric phakic IOL and an aphakic IOL (Ophtec BV) in 2 patients with a history of RK. Similarly, Gupta et al 10 reported 2 cases in which patients with a history of RK had implantation of a multifocal IOL in the nondominant eye and a monofocal IOL in the dominant eye. To our knowledge, this is the first report of a patient successfully treated with a pseudoaccommodating toric IOL following RK.…”

Section: Jcrs Online Case Reports 2014; 2:73-77 Q 2014 Ascrs and Escrsmentioning

confidence: 96%

Unilateral implantation of a pseudoaccommodating toric intraocular lens in 2 patients after radial keratotomy

Messenger

Ambati

2014

Journal of Cataract and Refractive Surgery Online Case Reports

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We report 2 cases involving patients with a history of radial keratotomy (RK) who presented with astigmatism and a cataract and were successfully treated with implantation of a pseudoaccommodating toric intraocular lens (IOL) (Trulign). The first patient presented with right-eye corrected distance visual acuity and corrected near visual acuity of 20/70 and 20/40, respectively. Following cataract extraction and IOL placement, the manifest refraction was À0.25 C0.50 Â 180. At 3 months, the uncorrected distance visual acuity (UDVA) and uncorrected near visual acuity (UNVA) in the right eye were 20/30 and 20/20, respectively. The second patient presented with UDVA in his left eye of 20/60. After cataract extraction and implantation of the same pseudoaccommodating toric IOL, he experienced 2 months of transient iritis. Three months after surgery, the left-eye UDVA and UNVA were 20/20. Given the known risk for long-term hyperopic shift and diurnal fluctuations following RK, these patients appeared to be ideal candidates for the pseudoaccommodating toric IOL.

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Spectacle Independence after Cataract Extraction in Post-Radial Keratotomy Patients Using Hybrid Monovision with ReSTOR® Multifocal and TECNIS® Monofocal Intraocular Lenses

Cited by 8 publications

References 7 publications

<p>Extended depth of focus lens implantation after radial keratotomy</p>

<p>Extended depth of focus lens implantation after radial keratotomy</p>

Implantation of a Multifocal Toric Intraocular Lens after Radial Keratotomy and Cross-Linking with Hyperopia and Astigmatism Residues: A Case Report

Unilateral implantation of a pseudoaccommodating toric intraocular lens in 2 patients after radial keratotomy

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