A simultaneous post-LASIK sequential bilateral implantation of multifocal IOLs aimed at refraction correction. A clinical case

Abstract

The article presents a clinical example of intraocular presbyopia correction in a patient who previously underwent laser vision correction by LASIK for mild myopia. Before the surgery, the distance VA mono- and binocular was 1.0, ADD for reading distance 40 cm +2.0 D, objective refraction sph +0.5 D cyl -0.25 D ax 980, left eye sph +0.75 D cyl -0.25 D ax 660. The patient was given a simultaneous bilateral refractive lens exchange with an implantation of a trifocal aspheric intraocular lens in the right eye and a trifocal toric aspheric intraocular lens in the left eye. We used the following IOL calculation formulas: ASCRS mean IOL power, Shammas formula, Barrett true K formula, Masket formula, Modified Masket formula, Haigis-L formula. 1 week postop: UDVA OU = 1.0, UNVA 40 cm = 1.0, UVA 70 cm = 0.7. The objective refraction OD was sph +0.0, D cyl -0.75 D ax 163, OS sph +0.25 D, cyl -0.0 D. The compliance with the modified algorithms of pre-and intraoperative behavior of the operating team, thorough preparation of the patient, careful calculation of the IOL allowed us to obtain the predictive refractive result with a high level of visual satisfaction and absence of undesirable postoperative phenomena. The patient underwent the examination with Salzburg reading desk before and after the surgery, to confirm the excellent functional results of the treatment. Despite the fact that simultaneous same day IOL implantation in both eyes, especially in eyes with previously operated corneas, is still disputable, the above case confirms that with modern equipment, precise multi formula calculation, and ample experience help achieve excellent functional and refractive results.

Keywords

• presbyopia
• immediate sequential bilateral refractive lens replacement
• multifocal iols