Use of Presbyopia-Correcting Intraocular Lenses in Patients With Prior Corneal Refractive Surgery

Majid Moshirfar; Andrew C. Thomson; Robert J. Thomson; Tanisha Martheswaran; Shannon E. McCabe


Curr Opin Ophthalmol. 2021;32(1):45-53. 

In This Article


With proper preoperative counseling, diagnostic evaluation, and surgical planning, it is possible for some postkeratorefractive patients to undergo presbyopia-correcting IOL implantation and achieve favorable outcomes[14,41,42,45–47] On the contrary, many of the available recommended preoperative thresholds are based on expert opinion or virgin corneas. Further clinical studies with standardized reporting of how preoperative factors – such as pupil diameter, keratometry, aberrometry, double-pass imaging, angle kappa, angle alpha, and prior refractive treatment amounts – influence outcomes and thresholds established. Analyses such as receiver operating curves are required to provide conclusive guidelines and should be the focus of future studies. Postoperatively modifiable IOLs technology may prove to be the next step in addressing the challenge of tolerable presbyopia-correcting IOLs in postkeratorefractive patients; however, current limitations of currently available modalities prevent universal implementation.