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Prevention of hyperopic surprise after LASIK in patients with refractive multifocal intraocular lenses
César Albarrán-Diego1, Gonzalo Muñoz, Teresa Ferrer-Blasco
1Refractive Surgery Department, Marqués de Sotelo Ophthalmological Center and Hospital NISA Valencia al Mar, Valencia, Spain. cesar.albarran@gmail.com
Purpose:
Three cases of patients who developed a similar hyperopic defect in refraction following laser in situ keratomileusis (LASIK) after multifocal intraocular lens (IOL) implantation are described.
Methods:
Ophthalmologic evaluation including refractive status, corrected and uncorrected visual acuity (both at far and near), and corneal topography in patients presenting similar hyperopic refractive surprise in one eye as a result of LASIK refinement of residual ametropia after refractive multifocal IOL implantation.
Results:
Laser in situ keratomileusis enhancement for residual ametropia of -1.00 to -1.50 D in patients with a prior implantation of refractive multifocal IOL resulted in a refractive surprise of +2.25 to +2.50 D. After excluding other possible sources of error, an explanation for such a refractive surprise is suggested, and a simple method for avoiding this error is presented.
Conclusions:
Proper knowledge of the defocus curve and the use of a systematic method for determining subjective refraction in patients implanted with refractive multifocal IOLs will reduce the possibility of refractive surprise after LASIK enhancement in a bioptics procedure.
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