Clinical Ophthalmology
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Clinical outcomes using standard phacoemulsification and femtosecond laser-assisted surgery with toric intraocular lenses This article was published in the following Dove Press journal: Clinical Ophthalmology 30 March 2016 Number of times this article has been viewed
Arnaldo Espaillat 1 Obniel Pérez 1 Richard Potvin 2 Espaillat-Cabral Eye Institute, Santo Domingo, Dominican Republic; 2 Science in Vision, Akron, NY, USA 1
Purpose: To compare the 1-month and 1-year results of toric intraocular lens (IOL) implantation with standard (manual) phacoemulsification vs femtosecond laser-assisted surgery. Patients and methods: Refractive data, visual acuity data, and ocular aberration measured with a wavefront aberrometer were collected for two groups of patients from one site. The first group had standard phacoemulsification, while the second group had femtosecond laser-assisted surgery, and both groups were implanted with toric IOLs, either monofocal or multifocal. Differences in visual acuity, refractive outcomes, and higher order aberrations – total, corneal, and internal – were evaluated at 1 month and 1 year postoperatively. Results: Toric IOLs were implanted in 62 eyes using standard phacoemulsification and 53 eyes using femtosecond laser-assisted surgery. Uncorrected visual acuity and best-spectacle-corrected visual acuity at 1 month and 1 year were not statistically significantly different between the groups (P.0.05) nor was the mean cylinder or mean spherical equivalent refraction (P.0.12). Total ocular higher order aberrations were significantly different between the groups (P,0.05), but absolute differences appeared to be the same. Internal vertical coma was significantly lower in the femto group at 1 year (P=0.03). Differences in aberrations did not correlate with corrected or uncorrected visual acuity. Conclusion: Patients who underwent uncomplicated lens surgery with toric IOLs in both the groups had comparable refractive outcomes in terms of visual acuity and residual refraction at 1 year. The femto group had significantly lower internal vertical coma at 1 year. Keywords: FLACS, LenSx, cataracts, refraction, astigmatism, visual acuity, toric IOL, femtosecond laser
Introduction
Correspondence: Richard Potvin Science in Vision, 6197 Dye Road, Akron, NY 14001, USA Tel +1 407 697 6008 Fax +1 716 442 5110 Email rick@scienceinvision.com
Approximately, a third of patients presenting for cataract surgery are likely to have clinically significant levels of corneal astigmatism.1 Toric intraocular lenses (IOLs) have been shown to be a safe and effective method of reducing astigmatism at the time of cataract surgery.2 However, after toric IOL implantation, residual astigmatism can still be problematic. Studies have reported residual astigmatism 1.0 D in ~10%–12% of eyes and spherical equivalent refractive errors 1.0 D in ~8% of eyes, with uncorrected visual acuity of 20/20 in 41%–63% of eyes.2,3 The amount of residual astigmatism is unlikely to be related to IOL rotation since the majority (93.3%)2 or all3 of the IOL rotation was #10°, though surgically induced astigmatism (SIA) and IOL tilt were not evaluated as possible causes for this residual astigmatism. The expectations for emmetropia are high among patients receiving toric IOLs; optimizing refractive results after cataract surgery is especially important for these patients. 555
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Clinical Ophthalmology 2016:10 555–563
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http://dx.doi.org/10.2147/OPTH.S102083