AUTHOR=Sun Yang , Hong Yingying , Rong Xianfang , Ji Yinghong 

TITLE=Presbyopia-Correcting Intraocular Lenses Implantation in Eyes After Corneal Refractive Laser Surgery: A Meta-Analysis and Systematic Review

JOURNAL=Frontiers in Medicine

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2022.834805

DOI=10.3389/fmed.2022.834805

ISSN=2296-858X

ABSTRACT=Purpose: To assess the efficacy, safety and predictability of presbyopia-correcting intraocular lenses (IOLs) in cataract patients with previous corneal refractive surgery.

Methods: A systematic literature search was performed to identify studies evaluating the clinical outcomes of presbyopia-correcting IOLs implantation in cataract surgery after laser refractive surgery. Outcomes were efficacy, safety and predictability parameters. 

Results: 
The authors identified 13 studies, involving a total of 128 patients and 445 eyes. Presbyopia-correcting IOLs were effective at improving distance, intermediate and near visual acuity aftercataract surgery. The proportion of post-laser surgery eyes with uncorrected distance visual acuity (UDVA) ≥ 20/25 was 0.82 (95% confidence interval [CI], 0.74 to 0.90) and the pooled rates of spectacle independence at near, intermediate, and far distances were 0.98 (95% CI, 0.94 to 1.00), 0.99 (95% CI, 0.95 to 1.00) and 0.78 (95% CI, 0.65 to 0.94) respectively. The percentage of participants who suffered from halos and glare was 0.40 (95% CI, 0.25 to 0.64) and 0.31 (95% CI, 0.16 to 0.60), respectively. The predictability had a percentage of 0.66 (95% CI, 0.57 to 0.75) and 0.90 (95% CI, 0.85 to 0.96) of eyes within ± 0.5 diopters (D) and ± 1.0D from the targeted spherical equivalent.

Conclusions: Presbyopia-correcting IOLs provide satisfactory results in terms of efficacy, safety and predictability in patients with previous corneal refractive surgery, but have a higher risk of photopic side effects such as halos and glare.