Laser vision correction plus RLE may be useful in hyperopia with astigmatism

April 18 - Washington, DC - Laser vision correction and refractive lens exchange (RLE) with a multifocal IOL may offer hope for hyperopic eyes with large amounts of astigmatism or residual astigmatism or eyes with presbyopia, according to Kevin L. Waltz, MD, who spoke about the results of retrospective chart review during a cataract/refractive symposium during the American Society of Cataract and Refractive Surgery annual meeting.

He reported on a retrospective chart review of 59 eyes of 34 patients who underwent either a planned bioptics procedure or a salvaged bioptics procedure. Some eyes were treated with LASIK before RLE because of extreme cylinder. PRK was performed after RLE in cases of residual astigmatism. LASIK was done after RLE to correct residual astigmatism and defocus.

In addition, RLE was an option after LASIK for defocus and presbyopia, Dr. Waltz said.

Most of the patients had hyperopia, although occasionally patients with extreme myopia were treated.

"The mean sphere was 3.74 D with a fairly wide standard deviation and a fair amount of cylinder," Dr. Waltz noted.

All patients were in the age range beyond the onset of presbyopia. All received the ARRAY multifocal IOL and most laser vision correction was performed with the VISX laser, he said.

Postoperatively, uncorrected visual acuity was good and uncorrected near vision was even better than best-corrected vision preoperatively.

"We find this pretty consistent of all our bioptic procedures and most of the refractive lens procedures for hyperopia," Dr. Waltz said.

However, longer-term follow-up is needed to determine the safety of bioptics.

To date, there have been no adverse complications at 2 years follow-up, he noted.