Eyeworld

DECEMBER 2021 | EYEWORLD | 57 R Contact Batliwala: shehzad@drbatliwala.com Rebenitsch: Dr.Luke@ClearSight.com Topography of both eyes when patient came in for lens replacement evaluation; right eye topography shows that even in the setting of post-hyperopic LASIK, the spherical aberration and overall ablation profile is conducive to having a multifocal placed in this eye; the left eye topography is in the presence of the KAMRA inlay Source (all): Shehzad Batliwala, DO, and Luke Rebenitsch, MD "He understood that there was an increased risk of halo and glare, but he wanted to have distance and near in both eyes," Dr. Rebenitsch said. Dr. Rebenitsch used a TECNIS ZKB00 (Johnson & Johnson Vision) +2.75 add in the right eye and a ZCB00 single focus lens in the left eye. At his 1-day postoperative exam, the patient was ecstatic. At 1 month after surgery, Dr. Rebenitsch said the patient still noticed some minor light sensitivity and foggy vision but now has vision better than he had with the KAMRA inlay initially. Dr. Rebenitsch shared several takeaways from this case. First, it's expected that patients will drift hyperopic. Even though the KAMRA inlay target is between –0.75 and –1.0 D, you will lose some of that depth of focus as people naturally drift more hyperopic and become more presbyopic. Dr. Rebenitsch said this case highlights the fact that in some instances, multifocal lenses can be a great option in post-hyperopic LASIK patients. The surgeon must ensure that the cor- nea is pristine with acceptable spherical aber- ration and minimal higher order aberrations. A well-centered ablation is critical. Dr. Rebenitsch noted that many surgeons have stopped using inlays. Because of the nat- ural hyperopic drift over time, some patients are coming back several years after their inlay procedures and are looking for a more perma- nent solution, he explained. Additionally, Dr. Rebenitsch said that he thinks multifocal lenses have achieved such a great level of quality that he typically opts for a RLE rather than an inlay. Shehzad Batliwala, DO, shared some thoughts on the case. He said he thinks it's important to note how this case demonstrates the advancement of modern LASIK in terms of the lasers and ablation profiles used to minimize optical aberrations. "We were still able to put a multifocal lens in this patient after having had hyperopic LASIK, which, 10–15 years ago, was unheard of," Dr. Batliwala said. "As excimer la- sers have improved their optics, this has allowed us to continue to use multifocal lenses in these types of patients."

• Blank Page
• Blank Page (1)