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This retrospective study is to evaluate refractive and visual outcomes of topography-guided femtosecond laser-assisted in situ keratomileusis (TGL) for correcting corneal high-order aberrations (HoA) after multifocal intraocular lens (mIOL) implantation. Twenty-eight eyes of 28 patients with both corrected distance visual acuity (CDVA) under 20/25 and subjective visual discomfort at 3 months after mIOL implantation were included in the study. TGL was performed to correct corneal HoA. Visual acuity, manifest refraction, and corneal HoA were measured 3 months after TGL. CDVA was improved in 22 (78.57%) of 28 eyes after TGL. Uncorrected distance visual acuity (0.12 ± 0.16 logMAR) and uncorrected near visual acuity (0.081 ± 0.16 logMAR) were better than those before TGL ( P  < 0.001). Residual refractive astigmatism showed no difference compared to that before TGL. Root mean square (RMS) of HoA ( P  = 0.012), spherical aberration ( P  = 0.013), and RMS of coma ( P  = 0.001) were reduced relative to those before TGL. Amount of improvement in CDVA was correlated with amount of reduced coma RMS (R = 0.524;  P  = 0.005) and spherical aberration (R = 0.443;  P  = 0.021). TGL showed to improve both refractive and visual outcomes in patients with mIOL implantation by correcting corneal HoA.

Clinical outcomes of topography-guided femtosecond laser-assisted in situ keratomileusis after multifocal intraocular lens implantation