Residual astigmatism after multifocal iol implantation prediction and possible management
Sponsored Links
This presentation is the property of its rightful owner.
1 / 12

Residual astigmatism after multifocal IOL implantation: prediction and possible management PowerPoint PPT Presentation


  • 85 Views
  • Uploaded on
  • Presentation posted in: General

ASCRS Boston 2010. Residual astigmatism after multifocal IOL implantation: prediction and possible management. Authors: Eva Vyplasilova, MD Katerina Buusova Smeckova, MD, MBA As. proff. Zdenek Smecka, MD, CSc. Klinika ocni a esteticke chirurgie in Zlin Czech Republic

Download Presentation

Residual astigmatism after multifocal IOL implantation: prediction and possible management

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


ASCRS Boston 2010

Residual astigmatism after multifocal IOL implantation: prediction and possible management

Authors: Eva Vyplasilova, MD

Katerina Buusova Smeckova, MD, MBAAs. proff. Zdenek Smecka, MD, CSc.

Klinika ocni a esteticke chirurgie in Zlin

Czech Republic

None of the authors has a financial interest on the presented data.


Aim

Methods

  • evaluation the satisfaction with unilateral and bilateral UCVA in patients after implantation of AcrySof ReSTOR +3 IOL.

  • prediction of the final refraction (mainly Dcyl) and overall patient satisfaction.

  • determination the amount of dioptries when patients usually request a laser enhancement

  • findning recommendations about suitable procedures to be chosen.

  • Dissatisfaction with optical phenomenons like halo, glare, speed of focusing, eye dryness and surgery or speed of recovery were not taken into account.

  • Preoperative BCVA, autorefractometry values and corneal astigmatism values from the IOL Master were measured. Lens clearness and pathologies were evaluated.

  • Standard cataract / RLE surgery was performed-Infinity phaco, incision 2,2mm, one surgeon, in the case of the higher astigmatism incision in the K max, no relaxation incisions.

  • Postoperatively was evaluated mono- and binocular UCVA, autorefractometry values, requests for glasses prescription, patient subjective satisfaction and laser enhancement rate- how many were requested and performed.

ASCRS Boston 2010


Setting / Venue

ASCRS Boston 2010


Results:

Refraction:

  • 0,33 Dsf +/- 0,48[-1,5; +2,50]

  • 0,50 Dcyl +/- 0,79 [-5; 0]

  • SE: 0,7 +/- 0,56 [-2,5; +2,6]

  • UCVA: 0,83 [0,2; 1,5]

    Subjectivesatisfaction:

  • satisfied: 390 eyes77 %

  • parctiallysatisfied: 95 eyes 19% ofeyes

  • unsatisfied: 23 eyes4%

    In 77%ofcaseswastheastigmatismdecreased,unchangedorincreased by no more than 0,1Dcyl.

ASCRS Boston 2010


Results- prediction of astigmatism

Group 0-0,5 Dcyl

Residual astigmatism

Preoperative on the average:

O,33Dcyl

0,39Dcyl [0; 1,25]

Postperative on the average:

55% orunchanged

x

45% (max. by 0,75Dcyl)

ASCRS Boston 2010


Results- prediction of astigmatism

Group 0,5- 1,0 Dcyl

Residual astigmatism

Preoperative on theaverage:

O,74Dcyl

0,54Dcyl[0; 1,75]

Postperative on the average:

82%orunchanged

x

18%

ASCRS Boston 2010


Results- prediction of astigmatism

Group 1,0– 1,5 Dcyl

Residual astigmatism

Preoperative on theaverage:

1,20Dcyl

0,71 Dcyl

Postperative on the average:

92% orunchanged

x

8%

ASCRS Boston 2010


Results- prediction of astigmatism

Group 1,5 Dcyl and more

Residual astigmatism

Preoperative on theaverage:

2,50Dcyl

1,9 Dcyl

Postperative on the average:

86% orunchanged

x

14%

ASCRS Boston 2010


ASCRS Boston 2010


ASCRS Boston 2010


Comparison with other means of correcting astigmatism

ASCRS Boston 2010


Conclusion

  • 80% of patients had post-operative astigmatism equal or better, so it is quite predictable.

  • We recommend to tailor the solution upon the pre-operative corneal astigmatism.

  • When pre-operative corneal astigmatism is higher than 1,0Dcyl, enhancement is highly possible.

  • When more than 1,5Dcyl is measured, enhancement or other correction means (toric IOL) should be planned.

  • Toric multifocal IOLs are technically very complex and according to our experience there might be a problem with their prediction and sometimes the dispersion in sphere or cylinder may be as high as 1,5D,

  • When the result with toric MIOL is not perfect, enhancement is necessary and this modality increases costs for the clinic and patients are often distempered.

  • That's why we prefer the alternative of MIOL followed by laser enhancement. The main disadvantage are 2 surgeries, but the result is precise.


  • Login