Effectiveness of different methods of correction of acquired ametropia after cataract, refractive and vitreoretinal surgery

Frequent cases of residual ametropia after ophthalmic surgical procedures indicate the relevance of performing a comparative analysis of the effectiveness of different methods of enhancement for acquired ametropia following cataract, refractive, and vitreoretinal surgery. The study, conducted between 2022 and 2025 at the medical center «Ochi Clinic», included 353 eyes of 353 patients with clinically significant acquired ametropia after ophthalmic surgical interventions. Patients were divided into four groups depending on the enhancement method: optical correction (150 eyes), intraocular lens exchange (60 eyes), laser keratorefractive enhancement (126 eyes), and implantation of an additional intraocular lens of the add-on type (17 eyes). All patients underwent standardized ophthalmological examination with assessment of uncorrected distance visual acuity, corrected distance visual acuity, manifest refraction, manifest refraction spherical equivalent, as well as biometric and corneal topographic parameters. The best functional and refractive outcomes were obtained in the laser enhancement group: uncorrected distance visual acuity at 6 months was 0.90±0.11, and the manifest refraction spherical equivalent was 0.12±0.49 diopters. Intraocular lens exchange and add-on intraocular lens implantation also provided significant improvement in visual function and refractive outcomes. Optical correction demonstrated the lowest efficacy index but maintained a high safety profile. Laser keratorefractive enhancement proved to be the most effective and predictable method for the correction of acquired ametropia, whereas intraocular lens exchange and add-on intraocular lens implantation represent appropriate alternatives for patients with significant residual refractive error or contraindications to laser procedures.

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