title: Outcomes of excimer laser enhancements in pseudophakic patients with multifocal intraocular lens.
abstract: OBJECTIVE
  The aim of this study was to assess visual and refractive outcomes of laser vision correction (LVC) to correct residual refraction after multifocal intraocular lens (IOL) implantation.
  
  
  METHODS
  In this retrospective study, 782 eyes that underwent LVC to correct unintended ametropia after multifocal IOL implantation were evaluated. Of all multifocal lenses implanted during primary procedure, 98.7% were refractive and 1.3% had a diffractive design. All eyes were treated with VISX STAR S4 IR excimer laser using a convectional ablation profile. Refractive outcomes, visual acuities, patient satisfaction, and quality of life were evaluated at the last available visit.
  
  
  RESULTS
  The mean time between enhancement and last visit was 6.3±4.4 months. Manifest spherical equivalent changed from -0.02±0.83 D (-3.38 D to +2.25 D) pre-enhancement to 0.00±0.34 D (-1.38 D to +1.25 D) post-enhancement. At the last follow-up, the percentage of eyes within 0.50 D and 1.00 D of emmetropia was 90.4% and 99.5%, respectively. Of all eyes, 74.9% achieved monocular uncorrected distance visual acuity 20/20 or better. The mean corrected distance visual acuity remained the same before (-0.04±0.06 logMAR [logarithm of the minimum angle of resolution]) and after LVC procedure (-0.04±0.07 logMAR; P=0.70). There was a slight improvement in visual phenomena (starburst, halo, glare, ghosting/double vision) following the enhancement. No sight-threatening complications related to LVC occurred in this study.
  
  
  CONCLUSIONS
  LVC in pseudophakic patients with multifocal IOL was safe, effective, and predictable in a large cohort of patients.
authors.affiliation: Department of Ophthalmology, University of California, San Francisco, CA, USA; Optical Express, Glasgow, UK; Department of Ophthalmology, University of Southern California, Los Angeles, CA, USA.
authors.forename: Steven C
authors.initials: SC
authors.lastname: Schallhorn
authors.affiliation: Optical Express, Glasgow, UK.
authors.forename: Jan A
authors.initials: JA
authors.lastname: Venter
authors.affiliation: Optical Express, Glasgow, UK.
authors.forename: David
authors.initials: D
authors.lastname: Teenan
authors.affiliation: Department of Ophthalmology, University of Southern California, Los Angeles, CA, USA.
authors.forename: Julie M
authors.initials: JM
authors.lastname: Schallhorn
authors.affiliation: Optical Express, Glasgow, UK.
authors.forename: Keith A
authors.initials: KA
authors.lastname: Hettinger
authors.affiliation: Optical Express, Glasgow, UK.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Hannan
authors.affiliation: Optical Express, Glasgow, UK.
authors.forename: Martina
authors.initials: M
authors.lastname: Pelouskova
keywords: excimer laser enhancements; multifocal IOL; pseudophakic patients