Presbyopia treatment raises questions for cataract surgery
In patients with cataracts who have previously undergone INTRACOR treatment for presbyopia, accurately determining the power of intraocular lenses (IOLs) can be challenging, according to a study.
The study found a tendency toward hyperopic outcomes, potentially affecting visual outcomes post-cataract surgery.
In this interventional case series involving 8 patients (10 eyes),
Patients (N = 8) involved in this interventional case series underwent cataract surgery 6.1 ± 3.2 years after receiving INTRACOR treatment from Technolas Perfect Vision GmbH. Of the 10 eyes included, 9 were implanted with a monofocal IOL, while 1 eye received a small-aperture IOL. The IOL power calculation was based on biometry obtained post-INTRACOR treatment, with additional calculations incorporating keratometry data collected prior to the INTRACOR procedure.
Following cataract surgery, the results showed a mean ± standard deviation (SD) uncorrected distance visual acuity of 0.37 ± 0.17 logMAR, corrected distance visual acuity of 0.10 ± 0.10 logMAR, and manifest refraction spherical equivalent of +0.39 ± 0.63 diopters (D), adjusted to infinity. However, outcomes for intermediate and near visual acuity, both corrected and uncorrected, as well as distance-corrected defocus curves, displayed significant variations across patients.
The study identified a challenge in accurately determining IOL power, particularly using biometry obtained after INTRACOR treatment. Traditional IOL power calculation formulas resulted in hyperopic outcomes, with a mean ± SD prediction error ranging from +0.72 ± 0.34 to +0.96 ± 0.41 D. Even when utilizing keratometry data acquired before INTRACOR, the accuracy improved but remained limited due to substantial variability.
Reference
Naujokaitis T, Hallak MK, Blöck L, et al. Refractive Outcomes of Cataract Surgery in Patients With Intrastromal Femtosecond Laser Treatment of Presbyopia (INTRACOR). J Refract Surg. 2023;39(10):676-682. doi: 10.3928/1081597X-20230831-02. Epub 2023 Oct 1. PMID: 37824299.
