PDF
ePub
Citation
Print
Abstract
Purpose
To study target refraction to improve visual quality in patients implanted with ReSTOR® SN6AD1 IOL (intraocular lens).
Methods
This study included 128 patients (160 eyes) that had undergone cataract surgery and who had a far visual acuity score higher than 0.8 after 6 months. These patients were divided into 4 groups. The uncorrected visual acuity (UCVA) at far and near were greater than 0.8 and better than J1 in the first group (Group 1), greater than 0.8 and worse than J1 in the second group (Group 2), less than 0.8 and better than J1 in the third group (Group 3) and less than 0.8 and worse than J1 in the last group (Group 4). We also compared the postoperative refractive errors of the four groups.
Results
At 6 months postoperatively, the spherical equivalent (SE) was -0.12 ± 0.51 in Group 1, 0.08 ± 0.54 in Group 2, -0.60 ± 0.60 in Group 3 and 0.02 ± 0.73 in Group 4. The SE value of Group 3 was significantly different compared to those of the other groups. Groups 1 and 3 who had better visual acuity at near distance show a negative value of SE, and Groups 3 and 4 who had worse visual acuity at far distance contained more individuals with an absolute value of SE greater than 0.5 compared to those in Groups 1 and 2.
Conclusions
The refractive power in multifocal IOL insertion is different from that used in monofocal IOL insertion. As the SE indicates a greater myopic shift, the visual acuity is better at near distance, and, when the absolute value of SE is greater than 0.5, the visual acuity at far distance is decreased.
Figures and Tables
Figure 1
Postoperative statistical comparison among the groups in spherical equivalent. Group 1 = distant visual acuity >0.8, near visual acuity >0.8; Group 2 = distant visual acuity >0.8, near visual acuity <0.8; Group 3 = distant visual acuity <0.8, near visual acuity >0.8; Group 4 = distant visual acuity <0.8, near visual acuity <0.8.
Figure 2
Distributions of postoperative spherical equivalents in histogram. (A) Group 1 = distant visual acuity >0.8, near visual acuity >0.8; (B) Group 2 = distant visual acuity >0.8, near visual acuity <0.8; (C) Group 3 = distant visual acuity <0.8, near visual acuity >0.8; (D) Group 4 = distant visual acuity <0.8, near visual acuity <0.8.
Table 1
Preoperative characteristics of participants
One-way ANOVA on Ranks, Kruskal-Wallis.
Values are presented as number or mean ± SD.
Group 1 = distant visual acuity >0.8, near visual acuity >0.8; Group 2 = distant visual acuity >0.8, near visual acuity <0.8; Group 3 = distant visual acuity <0.8, near visual acuity >0.8; Group 4 = distant visual acuity <0.8, near visual acuity <0.8.
UCDVA = uncorrected distant visual acuity.
Table 2
Postoperative comparison of visual acuity and spherical equivalent
The Kruskal-Wallis one way analysis of variance on ranks (Dunn's Method) is used in comparison of UCDVA and UCNVA and the one way ANOVA (Tukey test) is used in comparison of SE.
Values are presented as mean ± SD.
Group 1 = distant visual acuity >0.8, near visual acuity >0.8; Group 2 = distant visual acuity >0.8, near visual acuity <0.8; Group 3 = distant visual acuity <0.8, near visual acuity >0.8; Group 4 = distant visual acuity <0.8, near visual acuity <0.8.
UCDVA = uncorrected distant visual acuity; UCNVA = uncorrected near visual acuity; SE = spherical equivalent.
Table 4
Postoperative comparison of refraction
The one way ANOVA (Tukey test) is used in comparison of Total SE and the Kruskal-Wallis one way analysis of variance on ranks (Dunn's Method) is used in comparison of spherical diopter and cylindrical diopter.
Values are presented as mean ± SD.
Group 1 = distant visual acuity >0.8, near visual acuity >0.8; Group 2 = distant visual acuity >0.8, near visual acuity <0.8; Group 3 = distant visual acuity <0.8, near visual acuity >0.8; Group 4 = distant visual acuity <0.8, near visual acuity <0.8.
SE = spherical equivalent.
References
1. Toto L, Falconio G, Vecchiarino L, et al. Visual performance and biocompatibility of 2 multifocal diffractive IOLs: six-month comparative study. J Cataract Refract Surg. 2007. 33:1419–1425.
2. Alfonso JF, Fernández-Vega L, Amhaz H, et al. Visual function after implantation of an aspheric bifocal intraocular lens. J Cataract Refract Surg. 2009. 35:885–892.
3. Alfonso JF, Fernández-Vega L, Baamonde MB, Montés-Micó R. Prospective visual evaluation of apodized diffractive intraocular lenses. J Cataract Refract Surg. 2007. 33:1235–1243.
4. Zelichowska B, Rekas M, Stankiewicz A, et al. Apodized diffractive versus refractive multifocal intraocular lenses: optical and visual evaluation. J Cataract Refract Surg. 2008. 34:2036–2042.
5. Alfonso JF, Puchades C, Fernández-Vega L, et al. Visual acuity comparison of 2 models of bifocal aspheric intraocular lenses. J Cataract Refract Surg. 2009. 35:672–676.
6. Vingolo EM, Grenga P, Iacobelli L, Grenga R. Visual acuity and contrast sensitivity: AcrySof ReSTOR apodized diffractive versus AcrySof SA60AT monofocal intraocular lenses. J Cataract Refract Surg. 2007. 33:1244–1247.
7. Lee HS, Park SH, Kim MS. Clinical results and some problems of multifocal apodized diffractive intraocular lens implantation. J Korean Ophthalmol Soc. 2008. 49:1235–1241.
8. Yun J, Ahn K, Lee DH, et al. Spheric, aspheric ReSTOR intraocular lens: three-month results and preoperative clinical factors influencing patient's satisfaction. J Korean Ophthalmol Soc. 2010. 51:14–21.
9. Alfonso JF, Fernández-Vega L, Baamonde MB, Montés-Micó R. Correlation of pupil size with visual acuity and contrast sensitivity after implantation of an apodized diffractive intraocular lens. J Cataract Refract Surg. 2007. 33:430–438.
10. Hida WT, Motta AF, Kara-José N Junior, et al. Comparison between OPD-Scan results and visual outcomes of monofocal and multifocal intraocular lenses. Arq Bras Oftalmol. 2009. 72:526–532.
11. Webster MA. Adaptation and visual coding. J Vis. 2011. 05. 20. 11(5):pii: 3. doi: 10.1167/11.5.3. Print 2011.
12. Alió JL, Piñero DP, Plaza-Puche AB, Chan MJ. Visual outcomes and optical performance of a monofocal intraocular lens and a new-generation multifocal intraocular lens. J Cataract Refract Surg. 2011. 37:241–250.
13. Rocha KM, Chalita MR, Souza CE, et al. Postoperative wavefront analysis and contrast sensitivity of a multifocal apodized diffractive IOL (ReSTOR) and three monofocal IOLs. J Refract Surg. 2005. 21:S808–S812.
14. Chang M, Eom Y, Kang SY, et al. Clinical outcome of diffractive multifocal aspheric intraocular lens. J Korean Ophthalmol Soc. 2009. 50:529–536.
15. Cheon MH, Lee JE, Kim JH, et al. One-year outcome of monocular implant of aspheric multifocal IOL. J Korean Ophthalmol Soc. 2010. 51:822–828.
16. Hütz WW, Jäckel R, Hoffman PC. Comparison of visual performance of silicone and acrylic multifocal IOLs utilizing the same diffractive design. Acta Ophthalmol. 2010. 08. 17. [Epub ahead of print].
17. Bissen-Miyajima H, Minami K, Yoshino M, et al. Autorefraction after implantation of diffractive multifocal intraocular lenses. J Cataract Refract Surg. 2010. 36:553–556.
18. Muñoz G, Albarrán-Diego C, Sakla HF. Validity of autorefraction after cataract surgery with multifocal ReZoom intraocular lens implantation. J Cataract Refract Surg. 2007. 33:1573–1578.
19. Chang D. Mastering Refractive IOLs: The Art and Science. 2008. Thorofare, NJ: Slack Incorporated;542.
20. Lee ES, Lee SY, Jeong SY, et al. Effect of postoperative refractive error on visual acuity and patient satisfaction after implantation of the Array multifocal intraocular lens. J Cataract Refract Surg. 2005. 31:1960–1965.
21. Yoon JU, Chung JL, Hong JP, et al. Comparison of wavefront analysis and visual function between monofocal and multifocal aspheric intraocular lenses. J Korean Ophthalmol Soc. 2009. 50:195–201.
22. Smith G. Relation between spherical refractive error and visual acuity. Optom Vis Sci. 1991. 68:591–598.
23. Leone JF, Mitchell P, Morgan IG, et al. Use of visual acuity to screen for significant refractive errors in adolescents: Is it reliable? Arch Ophthalmol. 2010. 128:894–899.
24. Park CY, Chuck RS. Residual refractive error and visual outcome after cataract surgery using spherical versus Aspheric IOLs. Ophthalmic Surg Lasers Imaging. 2011. 42:37–43.
XML Download