The role of presbyopia-correcting intraocular lenses after laser in situ keratomileusis

PURPOSE OF REVIEW: There is a growing number of patients who wish to remain spectacle independent after cataract surgery, and this number includes some of the millions of people worldwide who have undergone laser in situ keratomileusis (LASIK). This article reviews the evidence of the use of presbyopia-correcting intraocular lenses (IOLs) in patients who have previously undergone LASIK. RECENT FINDINGS: Small studies have demonstrated that the use of hybrid refractive-diffractive multifocal IOLs in eyes with previous myopic or hyperopic LASIK can result in good refractive results. However, refractive surprise can be common and may require further intervention, such as laser surgery enhancement, to achieve satisfactory results. The use of these IOLs can also result in lost lines of vision, and visual quality may be poorer under mesopic or glare conditions. No reports were found regarding the use of accommodating IOLs in such patients. SUMMARY: There is a surprising paucity of literature on this topic, given the millions that have undergone LASIK. Further and timelier research is needed to assess the use of newer multifocal and accommodating IOLs in post-LASIK eyes, the effect of IOL asphericity on visual quality, and patients' experience, satisfaction and level of spectacle independence after surgery.