Optical and visual performance of diffractive intraocular lens implantation after myopic laser in situ keratomileusis

PURPOSE: To evaluate the optical and visual quality in eyes with diffractive intraocular lenses (IOLs) after myopic laser in situ keratomileusis (LASIK). SETTING: Fernández‐Vega Ophthalmological Institute, Oviedo, Spain. METHODS: The best corrected visual acuity (BCVA [distance]) at 12.5%, 25.0%, and 100% contrasts under photopic and mesopic conditions; best distance‐corrected near acuity; corneal total higher‐order aberrations (HOAs); and optical quality by modulation transfer function (MTF) were measured after myopic LASIK in eyes with a spherical AcrySof ReSTOR SN60D3 IOL or an aspheric Acri.LISA 366D IOL and phakic eyes (control). RESULTS: Under photopic conditions at 100% contrast, the BCVA was 0.1 logMAR or better in all groups. At 25.0% and 12.5% contrasts, there were no statistically significant differences between the aspheric IOL group and the spherical IOL or control group (P >.01). The control group had better BCVA than the spherical IOL group (P = .0002, 25.0%; P<.0001, 12.5%). Under mesopic conditions, the aspheric IOL group had better BCVA than the spherical IOL group at all contrasts (P<.01). There was no statistically significant difference between the 2 IOL groups in mean best distance‐corrected near acuity or between all 3 groups in HOAs (P >.01). With 6.0 mm and 3.0 mm pupils, there were no statistically significant differences in MTF between the aspheric IOL group and the control group; both groups had better MTF than the spherical IOL group with a 6.0 mm pupil (P<.01). CONCLUSION: After LASIK, the aspheric IOL provided better visual quality and optical quality than spherical IOL under mesopic conditions (large pupil).