Customized ablations following IOL implantation = spectacle independence

Following enhancement with IntraLase bioptics, nearly all patients with high preoperative astigmatism can achieve spectacle independence, according to Michael Knorz from the University Hospital, Mannheim, Germany.

Dr Knorz bilaterally implanted multifocal IOLs (Tecnis aspheric MF or ReZoom; AMO) into 14 patients with hyperopia and astigmatism of more than 2 D. A femtosecond-laser flap (IntraLase FS-60) of 100 microns and 9 mm was created immediately prior to lens surgery without lifting it. In eyes implanted with the Tecnis lens, a wavefront-guided ablation was performed, meanwhile in eyes implanted with the ReZoom lens, a standard ablation was performed with the Visx Star S4 (AMO) to fine tune the refraction.

Following implantation of the IOLs, average sphere was +0.85 and average cylinder was +1.04. After laser enhancement, sphere was +0.12 and cylinder +0.23. Higher order aberrations decreased significantly from 0.6 after IOL implantation to 0.32 after laser correction. No patient required spectacles postoperatively.

Dr Knorz believes that customized ablations following IOL implantation allows most patients to achieve spectacle independence and decreases the incidence of higher order aberrations.