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Session Title: Intraocular correction of presbyopia : multifocal IOLs, Monovision
Session Date/Time: Tuesday 08/10/2013 | 14:00-16:00
Paper Time: 14:40
Venue: Elicium 1 (First Floor)
First Author: : M.Neves PORTUGAL
Co Author(s): : T. Borges V. Miranda M. Lume R. Salgado M. Céu
To analyze refractive astigmatic changes and functional outcome after cataract surgery with diffractive multifocal toric intraocular lens (IOL) implantation.
Ophthalmology Department of Hospital de Santo António - Centro Hospitalar do Porto - Oporto, Portugal
Presbyopic patients evaluated from 07/2011 to 6/2012, with corneal astigmatism greater than 1 diopter, and indication for refractive lens extraction surgery (RLE), were proposed for RLE with ZEISS AT LISA 909M IOL implantation. This study assessed the functional and refractive outcome, topographic variation, IOL rotation and capsular opacification rate. A vectorial analysis of refractive astigmatic changes was made using the method of Alpins.
Sixteen eyes of eight patients were submitted to RLE with ZEISS AT LISA 909M implantation with a median follow-up of 9 months. The mean preoperative spherical equivalent (-4.76 diopters) and refractive astigmatism (3.38 diopters) were significantly reduced to -0.27 diopters and 0.52 diopters, respectively (p <0.05). The mean preoperative best corrected visual acuity (BCVA) improved from 0.18 logMAR to 0.10 logMAR at 9 months (p> 0.05), and the uncorrected visual acuity (VA) was 0.16 logMAR at 9th month. Preoperatively, 44% of eyes had J1 and 93% had J2 or better (BCVA, at 40 cm). At 9 months post-operatively, 57% had J1 and 86% had J2 or better (without any optical correction, at 40 cm). Topographical corneal astigmatism was stable (mean variation of -0.03) with a mean change of astigmatic axis of -2.07°. The mean deviation of the IOL axis relative to the axis of the surgical plan was +1.19°, and the intracapsular IOL rotation mean along the follow-up period was +0.38°. According to the Alpins vectorial analysis, the surgical induced astigmatism vectors mean (2.41 at 1st month, 2.32 at 9th month) was higher than the target induced astigmatism vectors mean (2.26).
In our series, multifocal toric IOLs AT LISA 909M were associated with a good refractive and functional outcome, keeping a good intracapsular rotational stability at 9 months follow-up, and allowing patients independence from glasses or contact lenses.
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