title: Clear lens extraction with intraocular lens followed by photorefractive keratectomy or laser in situ keratomileusis.
abstract: OBJECTIVE
  To study photorefractive keratectomy (PRK) or laser in situ keratomileusis (LASIK) after clear lens extraction (CLE) with intraocular lens (IOL) implantation for hyperopia or astigmatism.
  
  
  METHODS
  Retrospective, noncomparative interventional case series.
  
  
  METHODS
  Sixty-five eyes (55 subjects) had CLE with posterior chamber IOL implants for hyperopia up to 12.25 diopters (D); 31 eyes were retreated with PRK, and 34 eyes were retreated with LASIK for residual ametropias.
  
  
  METHODS
  For PRK and LASIK, the refractive surgery was performed with the slit-scanning excimer laser Nidek EC-5000, Nidek Co., Tokyo, Japan.
  
  
  METHODS
  Manifest refraction, best-spectacle and uncorrected Snellen visual acuity, haze, and halos were evaluated before surgery and at 1, 3, 6, and 12 months postoperative.
  
  
  RESULTS
  Forty-seven eyes were evaluated at the 12-month postoperative examination: 96% of these eyes had spherical equivalents (SE) within +/-2 D of emmetropia, 79% of eyes had SE within +/-1 D of emmetropia and 51% of eyes had SE within +/-0.50 D of emmetropia. Eighty-five percent of the eyes at 12 months postoperative had uncorrected visual acuity of 20/40 or better, and 46% of eyes had uncorrected visual acuity of 20/20 or better. Eighty-seven percent of the eyes at 12 months postoperative had uncorrected visual acuity within 1 Snellen line of their initial best spectacle-corrected visual acuity (BSCVA) before all treatment. No eye lost 2 Snellen lines of BSCVA at 3, 6, or 12 months after PRK or after LASIK.
  
  
  CONCLUSIONS
  IOL implantation for CLE, although an invasive technique, resulted in better refractive outcomes without laser-related clinical complications after PRK or LASIK adjustment.
authors.affiliation: Michel Pop Clinics, Montreal and Hull, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Pop
authors.forename: Y
authors.initials: Y
authors.lastname: Payette
authors.forename: M
authors.initials: M
authors.lastname: Amyot
mesh_terms: D000328:Adult; D000368:Aged; D001251:Astigmatism / Q000601:surgery*; D006801:Humans; D006956:Hyperopia / Q000601:surgery*; D020731:Keratomileusis, Laser In Situ; D054018:Lasers, Excimer; D019654:Lens Implantation, Intraocular; D007908:Lens, Crystalline / Q000601:surgery*; D008875:Middle Aged; D018903:Photorefractive Keratectomy; D011183:Postoperative Complications / Q000601:surgery*; D012029:Refraction, Ocular; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity