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Purpose. To report visual performance and quality of life after implantation of a bifocal diffractive multifocal intraocular lens (MIOL) in postmyopic laser in situ keratomileusis (LASIK) patients. Methods. Prospective, observational case series. Patients with prior myopic LASIK who had implantation of Tecnis ZMA00/ZMB00 MIOL (Abbott Medical Optics) at Hong Kong Sanatorium and Hospital were included. Postoperative examinations included monocular and binocular distance, intermediate and near visual acuity (VA), and contrast sensitivity; visual symptoms (0–5); satisfaction (1–5); spectacle independence rate; and quality of life. Results. Twenty-three patients (27 eyes) were included. No intraoperative complications developed. Mean monocular uncorrected VA at distance, intermediate, and near were 0.13±0.15 (standard deviation), 0.22±0.15, and 0.16±0.15, respectively. Corresponding mean values for binocular uncorrected VA were 0.00±0.10, 0.08±0.13, and 0.13±0.10, respectively. No eyes lost >1 line of corrected distance VA. Contrast sensitivity at different spatial frequencies between operated and unoperated eyes did not differ significantly (all P>0.05). Mean score for halos, night glare, starbursts, and satisfaction were 1.46±1.62, 1.85±1.69, 0.78±1.31, and 3.50±1.02, respectively. Eighteen patients (78%) reported complete spectacle independence. Mean composite score of the quality-of-life questionnaire was 90.31±8.50 out of 100. Conclusions. Implantation of the MIOL after myopic LASIK was safe and achieved good visual performance.

Background. The vision with diffractive toric multifocal intraocular lenses after cataract surgery in long eyes has not been studied previously. Objectives. To report visual performance after bilateral implantation of a diffractive toric multifocal intraocular lens in high myopes. Methods. Prospective, observational case series to include patients with axial length of ≥26 mm and corneal astigmatism of >1 dioptre who underwent bilateral AT LISA 909M implantation. Postoperative examinations included photopic and mesopic distance, intermediate, and near visual acuity; photopic contrast sensitivity; visual symptoms (0–5); satisfaction (1–5); and spectacle independence rate. Results. Twenty-eight eyes (14 patients) were included. Postoperatively, mean photopic monocular uncorrected distance, intermediate, and near visual acuities (logMAR) were 0.12±0.20 (standard deviation), 0.24±0.16, and 0.29±0.21, respectively. Corresponding binocular values were -0.01±0.14, 0.13±0.12, and 0.20±0.19, respectively. One eye (4%) had one-line loss in vision. Under mesopic condition, intermediate vision and near vision decreased significantly (all P≤0.001). Contrast sensitivity at all spatial frequencies did not improve significantly under binocular condition (all P>0.05). Median scores for halos, night glare, starbursts, and satisfaction were 0.50, 0.00, 0.00, and 4.25, respectively. Ten patients (71%) reported complete spectacle independence. Conclusions. Bilateral implantation of the intraocular lens in high myopes appeared to be safe and achieved good visual performance and high satisfaction.

Purpose. To report visual outcomes and patient satisfaction after unilateral or bilateral refractive lens exchange (RLE) with a single-piece bifocal diffractive multifocal intraocular lens (MIOL). Methods. All patients underwent RLE with the ZMB00 MIOL (Abbott Medical Optics). Patient charts were reviewed to evaluate the distance, intermediate, and near visual acuity (VA), contrast sensitivity, extent of visual symptoms (0–5), satisfaction (1–5), and rate of spectacle independence between unilateral and bilateral RLE group. Results. Forty-seven eyes of 28 patients were included. No intraoperative complications developed. Mean monocular uncorrected VA at distance, intermediate (67 cm), and near (30 cm) were 0.01±0.12 (standard deviation), 0.27±0.18, and 0.15±0.11, respectively. No eyes lost >1 line of corrected distance VA. Monocular contrast sensitivity remained at normal level. Median scores of halos, night glare, and starbursts for 27 patients were 2.0, 3.0, and 0.0, respectively. Median score of satisfaction was 4.0. There were no differences in visual symptom scores or satisfaction between unilateral and bilateral group (P>0.05). Eighty percent of 25 patients reported total spectacle freedom, with similar rate between bilateral (82%) and unilateral group (75%) (P=1.000). Conclusions. RLE with the bifocal diffractive MIOL was safe in presbyopic patients and resulted in a high rate of spectacle independence.