• José F Alfonso, Luis Fernández-Vega, Robert Montés-Micó, and Beatriz Valcárcel.
• Fernández-Vega Ophthalmological Institute, School of Medicine, University of Oviedo, Oviedo, Spain. j.alfonso@fernandez-vega.com
• Am. J. Ophthalmol. 2008 Aug 1; 146 (2): 244-250.

PurposeTo assess visual and refractive outcomes of femtosecond laser for residual refractive error correction after refractive lens exchange (RLE) with multifocal intraocular lens (IOL) implantation.DesignProspective, nonrandomized, masked observational case series (self-controlled).MethodsFifty-three eyes of 31 consecutive patients were submitted to femtosecond laser surgery after RLE with multifocal IOL implantation. Patients showed an average manifest refractive error (D) of M, 0.200 +/- 0.490; J(0), -0.051 +/- 0.532; and J45, -0.007 +/- 0.371. Visual acuity (VA) was measured at distance and near vision before and six months after the surgery.ResultsAt six months after surgery, mean uncorrected VA was 0.83 +/- 0.20 and improved in 100% of the eyes. No eye lost two or more lines of best-corrected distance VA; five eyes lost one line, 31 eyes did not change after the surgery, 13 eyes gained one line, and four eyes gained two lines. All eyes were within +/- 1.00 diopters (D) and 96.2% were within +/- 0.50 D of the desired refraction. The average manifest refractive error (D) after surgery was M, 0.014 +/- 0.170; J0, 0.029 +/- 0.118; and J45, 0.007 +/- 0.061. No eye lost two or more line of best distance-corrected near VA; two eyes lost one line, 40 eyes did not change, and 11 eyes gained one line. Mean uncorrected distance near VA was 0.88 +/- 0.12 at six months. Best distance-corrected near VA changed from 0.89 +/- 0.14 before surgery to 0.90 +/- 0.13 at six months.ConclusionsFemtosecond laser after RLE with multifocal IOL implantation is an effective procedure for correcting residual ametropia and resulted in better distance visual outcomes.

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