[Bioptics with multifocal lenses and Lasek].
OBJECTIVE
Good functional results with multifocal lenses need exact postoperative emmetropia. Therefore, it seems reasonable to perform additional refractive surgery to correct minimal spherical or cylindrical postoperative ametropia (bioptics). But concerns could arise about additional photoptic phenomena or loss of contrast. The literature contains only a few reports about bioptics after multifocal lens implantation.


METHODS
In eight eyes of seven patients, laser subepithelial keratomileusis (Lasek) was done after multifocal lens implantation. Pre-Lasek and 6 months postoperatively, we performed the following examinations in addition to visual acuity: contrast sensitivity (Pelli-Robson charts), low-contrast visual acuity (Humphrey AR 570), glare visual acuity (Humphrey AR 570), and night-driving ability (Mesoptometer II, Oculus).


RESULTS
Preoperative contrast sensitivity was 1.2-1.65; postoperatively it was 1.35-1.65. Low-contrast visual acuity measured 50-70% preoperatively and 57-70% postoperatively. Glare visual acuity measured 12.5-50% preoperatively and 28.5-57% postoperatively. Mesoptometer measurements did not change after Lasek; they revealed night-driving ability under strict criteria for four patients.


CONCLUSIONS
Bioptics as a combination of multifocal lens implantation and Lasek does not cause a functional decline in low-contrast or glare visual acuity, but it minimizes postoperative ametropia. It seems superior to exclusive multifocal lens implantation.
Liekfeld
A
A
Universitäts-Augenklinik, Charité, Campus Virchow-Klinikum, Humboldt-Universität, Augustenburger Platz 1, 13353 Berlin, Deutschland. anja.liekfeld@charite.de
Friederici
L
L
Rieck
P
P
D015350:Contrast Sensitivity; D005260:Female; D005500:Follow-Up Studies; D019466:Glare; D006801:Humans; D049008:Keratectomy, Subepithelial, Laser-Assisted; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008297:Male; D012030:Refractive Errors / Q000517:prevention & control*; D054140:Refractive Surgical Procedures; D013997:Time Factors; D016896:Treatment Outcome; D014792:Visual Acuity