Refractive results after implantation of a light-adjustable intraocular lens in postrefractive surgery cataract...

To evaluate whether postoperative refractive power adjustment of a light-adjustable lens (LAL; Calhoun Vision, Inc, Pasadena, CA) improves refractive outcomes in patients who have undergone prior LASIK or photorefractive keratectomy.

Retrospective case series.

Thirty-four eyes in 21 cataract patients with a mean age of 62.6 ± 9.7 years and a history of myopic corneal refractive surgery were implanted with the LAL during cataract surgery performed at a single clinic in Victoria, Canada.

Two weeks after uncomplicated cataract surgery, we used a light delivery device to deliver a spatially resolved 365-nm beam of ultraviolet light to alter the shape of the LAL and hence its refractive power. To obtain the desired refractive change, 1, 2, or 3 adjustments were used. After adjustments, we applied 2 lock-in treatments to the LAL to consume unpolymerized macromeres in the LAL. The final manifest refraction spherical equivalent (MRSE) achieved then was compared with the initial refractive target before LAL implantation.

The MRSE to target refraction, mean absolute error of cohort to target refraction, and percentage of cohort within ± 0.25 diopters (D), ± 0.50 D, ± 1.0 D, and more than ± 1.0 D relative to target refraction.

The MRSE relative to target refraction after final lock-in was within ± 0.25 D in 74% of eyes, within ± 0.50 D in 97% of eyes, and within ± 1.00 D in 100% of eyes. Mean absolute error was 0.19 D with a standard deviation of ± 0.20 D.

In patients with a history of laser refractive surgery, LAL implantation and postimplantation adjustment provide a precise refractive outcome.

The author(s) have no proprietary or commercial interest in any materials discussed in this article.