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. (c) 2018 ASCRS and ESCRS