Evaluation of Visual Acuity, Postoperative Refractive Error, and Optical Aberrations in Patients With Previous Corneal Surgery and AcrySof IQ Vivity Intraocular Lens Implantation

Purpose: To assess the visual outcomes, refractive accuracy, and visual disturbances in patients with a history of myopic laser-assisted in situ keratomileusis (LASIK) who underwent cataract surgery with extended depth of focus intraocular lens (IOL). Methods: This prospective interventional study included 26 eyes of 13 patients who had previously undergone myopic LASIK surgery. All the participants underwent bilateral phacoemulsification and implantation of the AcrySof IQ Vivity IOL between May 2023 and March 2024. Inclusion criteria included patients > 50 years of age with corneal higher-order aberrations < 0.6 and coma < 0.4. Exclusion criteria included glaucoma, macular disease, retinal detachment, and corneal disease. Visual acuity examinations were performed 1 and 3 months postoperatively. Results: Before surgery, the mean uncorrected distance visual acuity (UDVA) was 0.3 ± 0.08 logMAR, and the mean corrected distance visual acuity (CDVA) was 0.1 ± 0.03 logMAR. At 3 months follow-up, significant improvements in UDVA (0.04 ± 0.05 logMAR), intermediate (0.1 ± 0.09), and near visual acuity (0.27 ± 0.1) were noted. Postoperatively, 65.4% of the eyes achieved refractive outcomes within ±0.5 D of emmetropia, and 92.3% were within ±1 D. Quality of Vision (QoV) scores revealed no considerable changes following surgery. Conclusion: The AcrySof IQ Vivity IOL demonstrated good uncorrected distance and intermediate visual outcomes in patients with prior myopic LASIK, along with functionally acceptable near vision and good refractive predictability. These findings support the use of this extended-depth-of-focus lens as a viable solution for presbyopia correction in postrefractive surgery patients, with minimal impact on visual disturbances.