Femtosecond laser for residual refractive error correction after refractive lens exchange with multifocal intraocular lens implantation

PURPOSE: To assess visual and refractive outcomes of femtosecond laser for residual refractive error correction after refractive lens exchange (RLE) with multifocal intraocular lens (IOL) implantation. DESIGN: Prospective, nonrandomized, masked observational case series (self controlled). METHODS: Fifty-three eyes of 31 consecutive patients were submitted to femtosecond laser surgery after RLE with multifocal 101, implantation. Patients showed an average manifest refractive error (D) of M, 0.200 +/- 0.490; J(0), -0.051 +/- 0.532; and J(45), -0.007 +/- 0.371. Visual acuity (VA) was measured at distance and near vision before and six months after the surgery. RESULTS: At six months after surgery, mean uncorrected VA was 0.83 +/- 0.20 and improved in 100% of the eyes. No eye lost two or more lines of best-corrected distance VA; five eyes lost one line, 31 eyes did not change after the surgery, 13 eyes gained one line, and four eyes gained two lines. All eyes were within +/- 1.00 diopters (D) and 96.2% were within +/- 0.50 D of the desired refraction. The average manifest refractive error (D) after surgery was M, 0.014 +/- 0.170; J(0), 0.029 +/- 0.118; and J(45), 0.007 +/- 0.061. No eye lost two or more line of best distance-corrected near VA; two eyes lost one line, 40 eyes did not change, and 11 eyes gained one line. Mean uncorrected distance near VA was 0.88 +/- 0.12 at six months. Best distance,corrected near VA changed from 0.89 +/- 0.14 before surgery to 0.90 +/- 0.13 at six months. CONCLUSIONS: Femtosecond laser after RLE with multifocal 101, implantation is an effective procedure for correcting residual ametropia and resulted in better distance visual outcomes.