Rotationally Asymmetric Refractive Low Addition Multifocal IOL Implantation in Patients With Previous Corneal Laser Myopic Refractive Surgery.

Purpose: To evaluate the visual and refractive outcomes, retinal optical image quality, and patient satisfaction following implantation of a rotationally asymmetric refractive low addition multifocal intraocular lens (IOL) (Lentis Mplus; Te-leon) during cataract surgery in patients with prior myopic corneal laser refractive correction.

Methods: This observational, retrospective study included 35 eyes (26 patients) with previous laser corneal myopic refractive surgery that were implanted with the LENTIS Mplus (LS-313 MF15) multifocal IOL during cataract surgery. Refractive and visual outcomes were analyzed at 1, 3, and 6 months of follow-up. At the last visit (range: 7 to 130 months), monocular defocus curve and monocular contrast sensitivity were examined. Total ocular aberrometry was obtained with a pyramidal wavefront sensor (Osiris; CSO) at a 4-mm pupil diameter. Patient satisfaction was evaluated with the Quality of Vision (QoV) questionnaire and Near Activity Visual Questionnaire (NAVQ-10).

Results: A statistically significant improvement was observed in uncorrected and corrected distance visual acuity postoperatively (0.09 ± 0.12 and 0.03 ± 0.12 logarithm of the minimum angle of resolution [logMAR], respectively). Postoperative uncorrected near visual acuity remained nearly unchanged at good levels of 0.38 ± 0.23 logMAR and corrected near visual acuity was 0.09 ± 0.10 logMAR. The monocular defocus curve demonstrated high levels of visual acuity achieved at far and intermediate distances along with acceptable levels at near vision. The QoV questionnaire showed lower scores for frequency (29.12 ± 19.55), severity (29.26 ± 17.40), and bothersomeness (25.87 ± 17.42).

Conclusions: This study demonstrated efficacy and safety of a rotationally asymmetric refractive low addition multifocal IOL implanted in eyes with prior myopic corneal ablation. It provided good levels of patient satisfaction and spectacle independence.