To evaluate the visual outcome and optical quality in eyes with diffractive multifocal intraocular lens (DMIOL) implantation after myopic refractive surgery.

Nineteen eyes (15 patients) were implanted with AcriSof ReSTOR® SN6AD1, the aspheric DMIOL after myopic refractive surgery (laser-assisted in situ keratomileusis [LASIK] 14 eyes, photorefractive keratectomy [PRK] 4 eyes, laser-assisted subepithelial keratomileusis [LASEK] 1 eye). Preoperative and postoperative visual acuities and manifest refraction were measured. Preoperative corneal higher-order aberrations (HOAs) were measured using Hartmann-Shack (H-S) aberrometer in dilated pupils, and optical qualities were measured 1 month postoperatively using H-S aberrometer and a double-pass system under mesopic conditions. Patient satisfaction was investigated using a questionnaire at 2 months postoperatively.

Uncorrected distant and near visual acuities at postoperative 2 months were 0.11 ± 0.19, and 0.19 ± 0.12 (log MAR), respectively. Postoperative spherical equivalent (SE) of 16 eyes (84.2%) was within ±0.50 diopters (D) and all eyes were within ±1.00 D from emmetropia. Preoperative corneal and postoperative ocular spherical aberrations in a 4.0 mm pupil diameter were 0.08 ± 0.08 and 0.07 ± 0.07 (µm), respectively. Objective scatter index was 3.42 ± 1.71 and modulation transfer function (MTF) cut-off value was 21.03 ± 12.37 cpd. General satisfaction score was 3.52 ± 0.96 points out of 5, and 8 patients (11 eyes) were not satisfied with DMIOL implantation.

After DMIOL implantation in the eyes with previous myopic refractive surgery, postoperative SE was close to the target D, but optical qualities and patient satisfaction were poor.