Spectacle Independence after Cataract Extraction in Post-Radial Keratotomy Patients Using Hybrid Monovision with ReSTOR® Multifocal and TECNIS® Monofocal Intraocular Lenses

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Abstract

Background

We report 2 patients who have undergone radial keratotomy (RK) preceding ReSTOR ^® multifocal intraocular lens (IOL; Alcon, Fort Worth, Tex., USA) implantation in their nondominant eyes and TECNIS ^® monofocal IOL (Abbott Medical Optics, Abbott Park, Ill., USA) in their dominant eyes.

Methods

Retrospective review of 2 patients who underwent hybrid monovision with ReSTOR ^® multifocal and TECHNIS ^® monofocal IOLs at the time of cataract surgery after a remote history of RK.

Results

Implantation of the ReSTOR ^® multifocal and the TECHNIS ^® monofocal IOLs was successful, with no reported adverse events. The patients were able to achieve spectacle freedom.

Conclusion

We report a novel technique for the management of post-RK patients to optimize their chances for spectacle independence.

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Most cited references 10

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Refractive complications of cataract surgery after radial keratotomy.

J. Liu, R. J. Neil Emery, Jason R. Rock … (1989)

Four patients underwent cataract extraction with posterior chamber lens implantation several years after radial keratotomy. All four patients experienced an initial hyperopic shift caused by an early postoperative corneal flattening of greater than or equal to 1 diopter. This flattening partially regressed, leaving the patients with a mean of 0.42 diopter of persistent corneal flattening. We found the Binkhorst and the Holladay intraocular lens calculation formulas to be more accurate than the SRK II for these patients. Corneal curvature measured with the keratometer was less accurate for intraocular lens calculations than was a value derived by subtracting the refractive change induced by the radial keratotomy from the patients' keratometric measurements obtained before radial keratotomy.

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Optical and ultrasound measurement of axial length and anterior chamber depth for intraocular lens power calculation.

Norbert Pesztenlehrer, János Németh, O Fekete (2002)

To evaluate the precision, reproducibility, and applicability of an optical method based on partial coherence interferometry for intraocular lens (IOL) power calculation. Ultrasound laboratory of a university eye hospital. A prospective comparison of measurements made by the IOLMaster optical instrument (Carl Zeiss) and Ultrascan Digital 2000 contact ultrasound A-scan (Alcon) for IOL calculations was performed. Examined were 255 eyes of 134 persons (204 phakic, 47 pseudophakic, and 4 aphakic). The mean age of the patients was 67.9 years (range 7 to 94 years). The IOLMaster measurements were successful in more than 80% of cases: in 82%, 99%, and 99% for axial length (AL), anterior chamber depth (ACD), and keratometry measurements, respectively. The reproducibility of the AL and ACD measurements was very high (coefficient of variation 0.13% and 2.20%, respectively). The AL and ACD values were significantly larger with the IOLMaster (P <.001) than with the Ultrascan Digital 2000. The correlation between ultrasound and optical AL measurements was high (r = 0.985; P <.001); however, there was no correlation between ACD measurements (r = 0.079; P =.397). The corneal refractive power measurements of a Javal-type keratometer and the IOLMaster were highly correlated (r = 0.955; P <.001), with a mean difference of 0.2 diopter. The results show that measurements for IOL calculation are easy and precise with the optical method. It is a noncontact method, so no anesthesia is needed and there is no risk of infection.

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Optical and ultrasound measurement of axial length and anterior chamber depth for intraocular lens power calculation

János Németh, Orsolya Fekete, Norbert Pesztenlehrer (2003)

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Author and article information

Journal

Journal ID (nlm-ta): Case Rep Ophthalmol

Journal ID (iso-abbrev): Case Rep Ophthalmol

Journal ID (publisher-id): COP

Title: Case Reports in Ophthalmology

Publisher: S. Karger AG (Allschwilerstrasse 10, P.O. Box · Postfach · Case postale, CH–4009, Basel, Switzerland · Schweiz · Suisse, Phone: +41 61 306 11 11, Fax: +41 61 306 12 34, karger@karger.ch )

ISSN (Electronic): 1663-2699

Publication date Collection: May-Aug 2014

Publication date (Electronic): 22 May 2014

Publication date PMC-release: 22 May 2014

Volume: 5

Issue: 2

Pages: 157-161

Affiliations

[1] ^aUniversity of Utah School of Medicine, Salt Lake City, Utah, Calif., USA

[2] ^bUniversity of Utah Moran Eye Center, Salt Lake City, Utah, Calif., USA

[3] ^cGavin Herbert Eye Institute, University of California, Irvine, Calif., USA

Author notes

*Balamurali K. Ambati, MD, Moran Eye Center, 65 Mario Capecchi Dr., Salt Lake City, UT 84132 (USA), E-Mail bala.ambati@ 123456utah.edu

Article

Publisher ID: cop-0005-0157

DOI: 10.1159/000363372

PMC ID: 4067705

SO-VID: 440f5013-aea8-45cd-ba7d-5d7c04b79890

License:

This is an Open Access article licensed under the terms of the Creative Commons Attribution-NonCommercial 3.0 Unported license (CC BY-NC) (www.karger.com/OA-license), applicable to the online version of the article only. Users may download, print and share this work on the Internet for noncommercial purposes only, provided the original work is properly cited, and a link to the original work on http://www.karger.com and the terms of this license are included in any shared versions.

History

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References: 9, Pages: 5

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