Bioptics in phakic and pseudophakic intraocular lens with the Nidek EC-5000 excimer laser.
PURPOSE: To evaluate predictability, safety, stability, and complications related to bioptics in patients that received phakic and those that received pseudophakic intraocular lenses. Both groups had LASIK with the Nidek EC-5000 excimer laser following IOL implantation. METHODS: We evaluated retrospectively 281 eyes of 196 patients with posterior chamber phakic implantation (ICL) and 64 pseudophakic eyes of 55 patients. All patients had LASIK 1 month or more after the first surgery. We used a treatment zone of 5.5 mm with a 7.00-mm transition zone. The flap was made with the Automated Corneal Shaper (ACS). RESULTS: In the group of phakic ICL eyes with bioptics, preoperative mean spherical equivalent refraction was -5.50 D (range, -1.37 to -16.00 D). The first day after LASIK, mean spherical equivalent refraction was -0.06 D, and at 1 month, -0.40 D. In pseudophakic bioptics eyes, preoperative mean spherical equivalent refraction was -2.61 D (range, +0.50 to -5.50 D). The first day after LASIK it was +0.27 D, and 1 month after LASIK it was +0.09 D. The incidence of complications was similar in both groups of patients. The most frequent complication was keratitis sicca (approximately 10% in each group). Interstitial edema (2.1%) was present only in phakic bioptics eyes. No retinal complications were observed. Refraction was stable 4 years after surgery. Target achieved refraction was +/- 0.50 D, showing the predictability of the procedure. CONCLUSIONS: Predictability and safety were demonstrated according to results and absence of severe complications related with this technique. Older patients did not develop more complications than younger people; dry eye incidence was similar in both groups. In extreme myopia patients did not present retinal complications related to surgical procedures.