EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/1148281
I AUGUST 2019 | EYEWORLD | 47 Contact information Name: reported in implanting pseudoaccommoda- tive IOLs in RK eyes, but I've seen some very unhappy patients," said Douglas Koch, MD. "I find that RK patients are poor candidates for any of these lenses because there's so much irregularity in their corneas, and the refractive accuracy of the surgery is so poor. They already have a multifocal cornea, so to me it makes no sense to add multifocal optics on top of that." Dr. Williamson usually follows the same thought pattern. "Although you can occasionally get away with it in a simple four-cut RK, the increased corneal aberrations from RK preclude the additive effect from aberrations secondary to multifocals," he said. In Dr. Hoffman's hands, accommodating IOLs work well in this patient group because the multifocal corneas give patients better near vision than would result in a normal cornea. Additionally, there are no aberrations induced by the IOL. He also has found extended depth of focus lenses to be useful and well-tolerated in RK patients. "Extended depth of focus IOLs with toricity can be used if the central 3 to 4 mm of the cornea demonstrates regular astig- matism that appears to correlate with auto-ker- atometry and topography indices," he said. Dr. Hoffman avoids multifocal IOLs in patients with previous RK. "As with all presbyopia IOLs, the patient's attitude and reasonable expectations may ex- clude them from using them," he said. EXPERIENCE EYEWORLD EDUCATION EYEWORLD EDUCATION HUB EducationHub.EyeWorld.org • Symposia • Webinars • Clinical discussions • Clinical interviews • Related monographs • EyeWorld articles OSD Inflammation Toric IOLs LACS Presbyopia LVC Phaco Glaucoma About the doctors Richard Hoffman, MD Clinical associate professor of ophthalmology Casey Eye Institute Oregon Health and Science University Eugene, Oregon Douglas Koch, MD Professor and Allen, Mosbacher, and Law Chair in Ophthalmology Baylor College of Medicine Houston Charles Williamson, MD The Williamson Eye Center Outpatient Surgery Center for Sight Baton Rouge, Louisiana Dr. Williamson performs cataract surgery. The type of refractive surgery a patient has had can affect IOL selection post-cataract surgery. Source: Charles Williamson, MD