Extended depth of focus lens implantation after radial keratotomy

Abstract

Purpose

To identify the visual performance of radial keratotomy (RK) patients that have undergone cataract surgery with implantation of an extended depth of focus (EDOF) intraocular lens (IOL).

Design

Retrospective chart review with questionnaire.

Methods

Medical charts of patients with a history of RK that had undergone phacoemulsification with implantation of the Tecnis Symfony IOL (J&J Vision) were reviewed. Data collected included preoperative demographics, number of RK incisions, pupil size, and preoperative visual acuity and manifest refraction. Primary outcome measures of the study included postoperative uncorrected distance visual acuity (UCVA) and manifest refraction spherical equivalent (SE) at each follow-up visit. Secondary outcomes included results from a telephone questionnaire assessing visual performance and satisfaction.

Results

Twenty-four eyes of 12 patients were included. UCVA improved from an average Snellen equivalent 20/73 preoperatively to 20/33 at an average final follow-up of 6 months (P=0.0011), while average manifest SE improved from +1.68 D to −0.18 D (P<0.0001). At final follow-up, 15 of 24 eyes (62.5%) were at or within 0.5 D of target refraction, while 20 of 24 eyes (83.3%) were at or within 1.0 D. In total, 79% of eyes (19 of 24) had UCVA of 20/40 or better at distance. In the survey, 78% of patients reported satisfaction with their vision after surgery and 44% of patients reported being spectacle free for all tasks.

Conclusions

An EDOF lens implant can produce good visual outcomes and satisfaction in patients with a history of RK.

Keywords:

• radial keratotomy
• cataract
• intraocular lens

Acknowledgments

The authors would like to acknowledge Douglas Wallin OD and Keith Rasmussen OD for their conceptualization of the project and clinical insight in advancing care of patients with a history of radial keratotomy. Presented at: American Society of Cataract and Refractive Surgeons (ASCRS) Annual Meeting, Washington, DC, April 2018.

Disclosure

Drs Berdahl and Thompson have received consultant fees from Johnson and Johnson Vision. Dr Berdahl reports personal fees from Alcon, Allergan, Avedro, Aurea Medical, Bausch and Lomb, CorneaGen, Dakota Lions Eye Bank, Equinox, Expert Opinion, Glaukos, Gore, Imprimis/Harrow Health, Johnson and Johnson, Kala, Kedalion, MELT Pharmaceuticals, MicroOptx, New World Medical, Ocular Surgical Data, Ocular Theraputix, Omega Ophthalmic, Orasis, Oyster Point, RxSight, Surface INC, Tarsus, Tear Clear, Vittamed, Vance Thompson Vision, Verana Health, Visionary Ventures, Zeiss, during the conduct of the study. Dr Thompson reports personal fees from Alcon, Bausch & Lomb, Johnson & Johnson, Zeiss, during the conduct of the study and personal fees from Acufocus, Allergan, Allotex, Avellino, BRIM Biotechnology, Inc, Conjtac, CSO (Costruzione Strumenti Oftalmici), Equinox, Euclid Systems, eyeBrain Medical Inc, Eyedetec, EyeGate Pharma, Healthe, Imprimis, Mynosys, Novaliq, OPHTEC, ORA (Ora Inc), Oyster Point Pharma, Precision Lens, RxSight, SightSciences, Stuart Therapeutics, Tarsus Rx, TearClear, ThruFocus, Treehouse Health, Veracity, Visant, Visiometrics, Vivior AG, outside the submitted work. The authors report no other conflicts of interest in this work.