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Maximising Refractive Outcomes with an Extended Depth of Focus IOL
OBJECTIVE: To assess the impact of the magnitude of preoperative and postoperative corneal astigmatism on refractive outcomes in patients undergoing cataract surgery or lens exchange with an extended depth of focus intraocular lens. To compare visual outcomes of steep and temporal on-axis corneal in...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Bentham Open
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6174614/ https://www.ncbi.nlm.nih.gov/pubmed/30369992 http://dx.doi.org/10.2174/1874364101812010273 |
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author | Power, Barry Murphy, Rory Leccisotti, Antonio Moore, Tara Power, William O’Brien, Paul |
author_facet | Power, Barry Murphy, Rory Leccisotti, Antonio Moore, Tara Power, William O’Brien, Paul |
author_sort | Power, Barry |
collection | PubMed |
description | OBJECTIVE: To assess the impact of the magnitude of preoperative and postoperative corneal astigmatism on refractive outcomes in patients undergoing cataract surgery or lens exchange with an extended depth of focus intraocular lens. To compare visual outcomes of steep and temporal on-axis corneal incisions. SETTING: Department of Ophthalmology, Blackrock Clinic, Dublin, Ireland. DESIGN: Prospective cohort analysis. METHODS: Fifty-three consecutive adult patients (94 eyes) undergoing routine phacoemulsification with Symfony IOL implantation were analysed. Exclusion criteria: targets for mini-monovision, incomplete data, other ocular pathology. Data were prospectively collected on pre- and postoperative refraction, keratometry, distance vision, near vision, surgical wound site and Surgically Induced Astigmatism (SIA). RESULTS: The average postoperative monocular Uncorrected Distance and Near visual acuities (UDVA and UNVA) were 0.12 LogMAR (± 0.1) (6/7.5(+1)) and 0.34 LogMAR (± 0.09) respectively. The average binocular UDVA and UNVA were 0.05 (± 0.07) and 0.29 LogMAR (± 0.06) respectively. Low levels of preoperative corneal astigmatism (0-0.99 D) were associated with better LogMAR UDVA and UNVA when compared with higher levels (> 0.99 D): 0.11 (CI 0.103-0.107) vs. 0.206 (CI 0.122-0.290) (p =0.015, CI 95%) and 0.33 (CI 0.316 - 0.356) vs. 0.39 (CI 0.34-0.43) (p =0.034, CI 95%) respectively. When patients with steep on-axis corneal incisions were compared with temporal on-axis corneal incisions, no difference was detected in visual outcome or SIA. CONCLUSION: The Symfony IOL is an effective surgical means of addressing presbyopia and reducing postoperative spectacle dependence. We stress caution when offering potential spectacle independence for patients with over 1D of preoperative corneal astigmatism as these patients achieve statistically significantly inferior and less predictable visual results. |
format | Online Article Text |
id | pubmed-6174614 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Bentham Open |
record_format | MEDLINE/PubMed |
spelling | pubmed-61746142018-10-26 Maximising Refractive Outcomes with an Extended Depth of Focus IOL Power, Barry Murphy, Rory Leccisotti, Antonio Moore, Tara Power, William O’Brien, Paul Open Ophthalmol J Ophthalmology OBJECTIVE: To assess the impact of the magnitude of preoperative and postoperative corneal astigmatism on refractive outcomes in patients undergoing cataract surgery or lens exchange with an extended depth of focus intraocular lens. To compare visual outcomes of steep and temporal on-axis corneal incisions. SETTING: Department of Ophthalmology, Blackrock Clinic, Dublin, Ireland. DESIGN: Prospective cohort analysis. METHODS: Fifty-three consecutive adult patients (94 eyes) undergoing routine phacoemulsification with Symfony IOL implantation were analysed. Exclusion criteria: targets for mini-monovision, incomplete data, other ocular pathology. Data were prospectively collected on pre- and postoperative refraction, keratometry, distance vision, near vision, surgical wound site and Surgically Induced Astigmatism (SIA). RESULTS: The average postoperative monocular Uncorrected Distance and Near visual acuities (UDVA and UNVA) were 0.12 LogMAR (± 0.1) (6/7.5(+1)) and 0.34 LogMAR (± 0.09) respectively. The average binocular UDVA and UNVA were 0.05 (± 0.07) and 0.29 LogMAR (± 0.06) respectively. Low levels of preoperative corneal astigmatism (0-0.99 D) were associated with better LogMAR UDVA and UNVA when compared with higher levels (> 0.99 D): 0.11 (CI 0.103-0.107) vs. 0.206 (CI 0.122-0.290) (p =0.015, CI 95%) and 0.33 (CI 0.316 - 0.356) vs. 0.39 (CI 0.34-0.43) (p =0.034, CI 95%) respectively. When patients with steep on-axis corneal incisions were compared with temporal on-axis corneal incisions, no difference was detected in visual outcome or SIA. CONCLUSION: The Symfony IOL is an effective surgical means of addressing presbyopia and reducing postoperative spectacle dependence. We stress caution when offering potential spectacle independence for patients with over 1D of preoperative corneal astigmatism as these patients achieve statistically significantly inferior and less predictable visual results. Bentham Open 2018-09-28 /pmc/articles/PMC6174614/ /pubmed/30369992 http://dx.doi.org/10.2174/1874364101812010273 Text en © 2018 Power et al. https://creativecommons.org/licenses/by/4.0/legalcode This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: (https://creativecommons.org/licenses/by/4.0/legalcode). This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Ophthalmology Power, Barry Murphy, Rory Leccisotti, Antonio Moore, Tara Power, William O’Brien, Paul Maximising Refractive Outcomes with an Extended Depth of Focus IOL |
title | Maximising Refractive Outcomes with an Extended Depth of Focus IOL |
title_full | Maximising Refractive Outcomes with an Extended Depth of Focus IOL |
title_fullStr | Maximising Refractive Outcomes with an Extended Depth of Focus IOL |
title_full_unstemmed | Maximising Refractive Outcomes with an Extended Depth of Focus IOL |
title_short | Maximising Refractive Outcomes with an Extended Depth of Focus IOL |
title_sort | maximising refractive outcomes with an extended depth of focus iol |
topic | Ophthalmology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6174614/ https://www.ncbi.nlm.nih.gov/pubmed/30369992 http://dx.doi.org/10.2174/1874364101812010273 |
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