Laser vision correction after cataract surgery may correct ametropia

April 18 - Washington, DC - Could laser vision correction be a safer alternative to IOL exchange in patients with ametropia after cataract surgery? That is the question that Irene C. Kuo, MD, and her colleagues tried to answer in a small study of patients who underwent LASIK or PRK to correct this problem.

Dr. Kuo presented the results of a retrospective, non-comparative study of 10 cataract surgery patients, including 7 men and 3 women, who had undergone laser refractive surgery for postoperative cataract surgery ametropia. Patients' charts showed that patients' average age was 75 and the average time between cataract surgery and laser surgery was 47 months. All the patients were implanted with a 3-piece PMMA lens except for 1 patient.

Nine patients had wanted to achieve emmetropia after cataract surgery. One patient had wanted monovision but the correction was -3 D. Patients were treated with the VISX excimer laser and the Bausch & Lomb Hansatome or AMO Amadeus keratome between Jan. 1, 1997 and Oct. 1, 2004.

The mean uncorrected visual acuity (UCVA) prior to laser vision correction was 20/400 and after PRK or LASIK, UCVA improved to 20/30. The median best spectacle-corrected visual acuity (BSCVA) was 20/25 and remained at that level after laser vision correction, Dr. Kuo noted.

IOL exchange can be problematic because it can lead to inflammation, corneal decompensation, glaucoma, and cystoid macular edema, she emphasized.

"Excimer laser surgery was a safe, effective off-label surgical method to correct ametropia after cataract surgery in a small series of elderly patients with short follow-up," Dr. Kuo said.

"In the future, one might be interested in looking at custom ablation, especially since this is now available. Longer follow-up and randomization of patients would be helpful. We should also be aware of how age affects corneal would healing," she concluded.