Comparative Analysis of Clinical Outcomes of a Monofocal and an Extended-range-of-vision Intraocular Lens In eyes with Previous Myopic Laser In situ Keratomileusis

Purpose: To compare the clinical outcomes after cataract surgery with implantation of a monofocal or an extended-range-of-vision intraocular lens (IOL).

Setting: Hospital da Luz, Lisbon Portugal.

Design: Prospective case series.

Methods: Patients who previously had myopic laser in situ keratomileusis (LASIK) had cataract surgery with bilateral implantation of an extended-range-of-vision IOL (Tecnis Symfony) or a monofocal IOL (Tecnis ZCB00). Visual acuity, refraction, defocus curve, contrast sensitivity, photic phenomena, spectacle independence, and patient satisfaction were evaluated at 4 months postoperatively.

Results: The study comprised 44 patients (88 eyes), with 22 patients in each IOL group. No significant differences between groups were found postoperatively for most visual and refractive parameters (all P ≥ .27). However, binocular uncorrected intermediate and near visual acuities were significantly better in the extended-range-of-vision group (P < .01). The defocus curve of both IOLs differed more with increasing negative defocus (P < .01). No significant differences between IOLs were found in contrast sensitivity for any spatial frequency evaluated (P ≥ .05). Most of the patients did not perceive photic phenomena with either IOL. Mild glare was reported in 22.7% of the extended-range-of-vision patients and 9.1% of the monofocal group; mild halos were comparable with 13.6% in both groups. Spectacle dependence for intermediate vision and near vision was higher in the monofocal IOL group.

Conclusion: The extended-range-of-vision IOL was a useful option to restore visual function after cataract surgery in eyes that previously had myopic LASIK surgery, offering levels of visual quality comparable to those achieved with the monofocal IOL.