Clinical outcomes according to the functional classification of intraocular lenses based on depth-of-field after myopic Laser in situ Keratomileusis

PURPOSE: To compare refractive predictability and functional visual outcomes among three depth-of-field (DOFi)-based intraocular lens (IOL) categories in eyes with previous myopic laser in situ keratomileusis (LASIK). SETTING: A single-center, university-affiliated hospital. DESIGN: Retrospective comparative cohort study. METHODS: 90 eyes of 45 patients who underwent bilateral cataract surgery after myopic LASIK were classified according to implanted IOL type: Full-DOFi Smooth (Tecnis Synergy), Partial-DOFi Enhanced (Eyhance), and Partial-DOFi Extended IOLs (PureSee). Distance-corrected visual acuity, monocular distance-corrected defocus curves, DOFi at 0.2 logMAR, refractive predictability with Barrett True-K TK and Haigis TK after IOL-specific optimization or mean prediction error zeroing, and patient-reported satisfaction were evaluated 3 months postoperatively. RESULTS: Corrected distance and intermediate visual acuities were comparable among groups (P = .967 and .780), whereas corrected near visual acuity differed (P < .001), favoring Full-DOFi Smooth, followed by Partial-DOFi Extended and Partial-DOFi Enhanced. DOFi was 3.22, 2.23, and 1.56 D, respectively. Prediction errors within ±0.50 D ranged from 76.7% to 83.3% with Barrett True-K TK and 70.0% to 73.3% with Haigis TK. Eyetemis analysis showed no trueness differences; Barrett True-K TK showed better precision and accuracy only in the Full-DOFi Smooth group. Near-vision satisfaction differed among groups, whereas pairwise glare/halo differences were not significant. CONCLUSION: In selected post-myopic LASIK eyes, expected DOFi-based functional differences remained evident after correction of residual refractive error. Barrett True-K TK and Haigis TK showed generally comparable refractive performance. These findings indicate that DOFi-based functional classification remains clinically relevant in eyes with previous myopic LASIK.