RESUMO

Purpose: To validate a new methodology to evaluate the impact of astigmatism in pseudophakia using an astigmatic defocus curve. Setting: Hospital Oftalmológico de Brasilia, Brazil. Design: Non-randomized cohort study. Methods: For every point of the defocus curve, from -2.00 to +3.00 with 0.50D intervals, visual acuity was assessed with optically induced astigmatism (0.50D, 1.00D and 1.50D at 90 and 180 degrees) in pseudophakic patients implanted with a refractive-enhanced intraocular lens. Results: Twelve patients were analyzed. A statistically significant difference was found between the 90° (ATR) and 180°(WTR) axis with 1.50D astigmatism, providing better visual acuity in ATR astigmatism (p < 0.05). Conclusion: This new methodology is reproducible, useful and may predict residual astigmatism tolerance in pseudophakic patients, which may help with surgery planning and IOL decision-making.

RESUMO

Purpose: To analyze whether femtosecond laser-assisted surgery leads to less cumulative dissipated energy (CDE) and decreased endothelial cell loss compared to conventional surgery. Patients and Methods: This non-blinded, non-randomized, quasi-experimental clinical trial was conducted at one center and involved one surgeon. Patients with cataracts and 50-80 years old were included, and the exclusion criteria were radial keratotomy, trabeculectomy, drain tube implant, corneal transplant, posterior vitrectomy, and re-implantation of intraocular lens. In total, 298 patients were recruited between October 2020 and April 2021, and the data collected included sex, laterality, age, ocular comorbidities, systemic comorbidities and CDE. An endothelial cell count was performed before and after surgery. Patients were divided according to femtosecond laser-assisted phacoemulsification or conventional phacoemulsification. The femtolaser patients were submitted to the equipment, and then, immediately after treatment, phacoemulsification surgery was performed. In the conventional method, the "divide and conquer" technique was used. The statistical analysis was made using an analysis of covariance linear model, using SAS version 9.4 (SAS Institute, Inc., 1999). Values with p < 0.05 were considered significant. Results: A total of 132 patients were analyzed. The only statistically relevant predictors of CDE were the severity of the cataract (p < 0.0001) and age of ≥75 years (p = 0.0003). The following factors were not significant: technique with or without laser (p = 0.6862), sex (p = 0.8897), systemic arterial hypertension (p = 0.1658), and diabetes (p = 0.9017). Grade 4 cataracts were associated with higher CDE than grade 3 cataracts, which in turn were associated with higher CDE than grade 2 cataracts. A comparison of pre- and post-operative specular microscopy with and without laser revealed no significant discrepancy (p = 0.5017). Conclusion: Femtosecond laser-assisted cataract surgery did not reduce CDE or endothelial cell loss compared to conventional surgery regardless of severity.

RESUMO

PURPOSE: The aim of this study was to compare the visual outcomes and subjective visual quality between bilateral implantation of an extended depth of focus intraocular lens, J&J Vision Tecnis Symfony® ZXR00 (Group A) and bilateral implantation of a diffractive trifocal intraocular lens, Alcon Acrysof IQ PanOptix® TNFT00 (Group B). METHODS: This prospective, nonrandomized, comparative study of consecutive cases assessed 52 eyes of 26 patients operated on by the same surgeon (WTH) and binocularly implanted with multifocal intraocular lenses between May 2016 and July 2018. Binocular visual acuity for far, intermediate and near was tested in all cases. Ophthalmological evaluation included the measurement of binocular uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected near visual acuity (UNVA) at 40 cm, uncorrected intermediate visual acuity (UIVA) at 70 cm, monocular visual defocus curve and the quality of life (QoL) questionnaire, National Eye Institute Visual Functioning Questionnaire - 25 ( NEI-VFQ 25). RESULTS: Postoperative UDVA was 0.00 and 0.09 logMAR (P<0.001), UIVA was 0.20 and 0.39 logMAR (P<0.001) and UNVA was 0.16 and -0.01 logMAR (P<0.001) in groups A and B, respectively; postoperative CDVA was -0.05 and 0.06 logMAR (P<0.001) in groups A and B, respectively. CONCLUSION: Both groups reported good subjective quality of vision regarding long, intermediate and short distances. Group A had a better performance for binocular UDVA, UIVA at 70 cm and CDVA, while regarding the monocular defocus curve, Group A outperformed Group B for long distances. Furthermore, Group B surpassed it in the short to very short distances, between the range of ≥2.00 D to 5.00 D of vergence. While Group A had a better performance regarding the vergences between 0.00 and 1.00 D (P<0.05) and at the vergence of +2.50 D (P=0.007). Group B outran Group A for UNVA at 40 cm.

RESUMO

PURPOSE: To compare visual outcomes and performance between bilateral implantation of a diffractive trifocal intraocular lens (IOL) Acrysof®PanOptix® TFNT00 and blended implantation of two different near add power bifocal IOLs: Acrysof® Restor® SV25T0 in dominant eye and Acrysof® Restor® SN6AD1 in the nondominant eye. METHODS: This prospective, nonrandomized, consecutive and comparative study assessed 20 patients (40 eyes) who had bilateral cataract surgery performed using the IOLs described. Patients were divided into groups, bilateral trifocal implant and blended implant. Evaluation included measurement of binocular uncorrected and corrected distance visual acuity at 4 m (UDVA, CDVA) and uncorrected intermediate (60 cm) and near (at 40 cm) visual acuity; contrast sensitivity (CS) and visual defocus curve. RESULTS: Postoperative CDVA comparison showed no statistical significance between groups. UDVA was significantly better in the trifocal groups. Under photopic conditions, the trifocal group had better CS in higher frequencies with and without glare. The binocular defocus curve demonstrated a trifocal behavior in both groups, with the bilateral trifocal group exhibiting better performance for intermediate vision. CONCLUSION: Both lens combinations were able to provide good near, intermediate and distance vision, with the trifocal group showing significantly better performance at intermediate distances and better CS under photopic conditions.

RESUMO

PURPOSE: To compare the optical performance and visual outcomes between two diffractive multifocal lenses: AMO Tecnis® ZMB00 and AcrySof® ReSTOR® SN6AD1. METHODS: This prospective, non-randomized comparative study included the assessment of 74 eyes in 37 patients referred for cataract surgery and candidates for multifocal intraocular lens implants. Exclusion criteria included existence of any other eye disease, previous eye surgery, high axial myopia, preoperative corneal astigmatism of >1.00 cylindrical diopter (D), and intraoperative or postoperative complications. Ophthalmological evaluation included the measurement of uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), distance-corrected near visual acuity (DCNVA), and distance-corrected intermediate visual acuity (DCIVA), with analysis of contrast sensitivity (CS), wavefront, and visual defocus curve. RESULTS: Postoperative UDVA was 0.09 and 0.08 logMAR in the SN6AD1 and ZMB00 groups, respectively (p=0.868); postoperative CDVA was 0.04 and 0.02 logMAR in the SN6AD1 and ZMB00 groups, respectively (p=0.68); DCIVA was 0.17 and 0.54 logMAR in the SN6AD1 and ZMB00 groups, respectively (p=0.000); and DCNVA was 0.04 and 0.09 logMAR in the SN6AD1 and ZMB00 groups, respectively (p=0.001). In both cases, there was an improvement in the spherical equivalent and UDVA (p<0.05). Under photopic conditions, the SN6AD1 group had better CS at low frequencies without glare (p=0.04); however, the ZMB00 group achieved better sensitivity at high frequencies with glare (p=0.003). The SN6AD1 and ZMB00 lenses exhibited similar behavior for intermediate vision, according to the defocus curve; however, the ZMB00 group showed a shorter reading distance than the SN6AD1 group. There were no significant differences regarding aberrometry between the two groups. CONCLUSION: Both lenses promoted better quality of vision for both long and short distances and exhibited a similar behavior for intermediate vision. The SN6AD1 and ZMB00 groups showed better results for CS under photopic conditions at low and high spatial frequencies, respectively.

Assuntos

Implante de Lente Intraocular/métodos , Lentes Intraoculares , Acuidade Visual/fisiologia , Aberrometria , Idoso , Análise de Variância , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Período Pré-Operatório , Desenho de Prótese , Valores de Referência , Refração Ocular , Resultado do Tratamento

RESUMO

ABSTRACT Purpose: To compare the optical performance and visual outcomes between two diffractive multifocal lenses: AMO Tecnis® ZMB00 and AcrySof® ReSTOR® SN6AD1. Methods: This prospective, non-randomized comparative study included the assessment of 74 eyes in 37 patients referred for cataract surgery and candidates for multifocal intraocular lens implants. Exclusion criteria included existence of any other eye disease, previous eye surgery, high axial myopia, preoperative corneal astigmatism of >1.00 cylindrical diopter (D), and intraoperative or postoperative complications. Ophthalmological evaluation included the measurement of uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), distance-corrected near visual acuity (DCNVA), and distance-corrected intermediate visual acuity (DCIVA), with analysis of contrast sensitivity (CS), wavefront, and visual defocus curve. Results: Postoperative UDVA was 0.09 and 0.08 logMAR in the SN6AD1 and ZMB00 groups, respectively (p=0.868); postoperative CDVA was 0.04 and 0.02 logMAR in the SN6AD1 and ZMB00 groups, respectively (p=0.68); DCIVA was 0.17 and 0.54 logMAR in the SN6AD1 and ZMB00 groups, respectively (p=0.000); and DCNVA was 0.04 and 0.09 logMAR in the SN6AD1 and ZMB00 groups, respectively (p=0.001). In both cases, there was an improvement in the spherical equivalent and UDVA (p<0.05). Under photopic conditions, the SN6AD1 group had better CS at low frequencies without glare (p=0.04); however, the ZMB00 group achieved better sensitivity at high frequencies with glare (p=0.003). The SN6AD1 and ZMB00 lenses exhibited similar behavior for intermediate vision, according to the defocus curve; however, the ZMB00 group showed a shorter reading distance than the SN6AD1 group. There were no significant differences regarding aberrometry between the two groups. Conclusion: Both lenses promoted better quality of vision for both long and short distances and exhibited a similar behavior for intermediate vision. The SN6AD1 and ZMB00 groups showed better results for CS under photopic conditions at low and high spatial frequencies, respectively.

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RESUMO Objetivo: Comparar o desempenho óptico e resultado visual entre duas lentes multifocais difrativas: AMO Tecnis® ZMB00 e AcrySof® ReSTOR® SN6AD1. Métodos: O estudo prospectivo, comparativo não randomizado incluiu avaliação de 74 olhos em 37 pacientes com indicação de facectomia e candidatos a implante de lente multifocal. Critérios de exclusão foram: presença de outras doenças oculares; cirurgia ocular prévia; alta miopia axial; astigmatismo cornenano maior que 1,00 D cilíndrica; complicações intraoperatórias ou pós-operatórias. A avaliação oftalmológica contou com medida da acuidade visual para longe corrigida (CDVA) e não corrigida (UDVA), intermediária (DCIVA) e curta distância (DCNVA) com melhor correção óptica para longe; teste de sensibilidade ao contraste; análise de frente de onda e curva visual de Defocus. Resultados: A UDVA foi de 0,09 logMAR para o grupo SN6AD1 e 0,08 logMAR para o grupo ZMB00; com correção foi de 0,04 logMAR para SN6AD1 e 0,02 para o grupo ZMB00 (p>0,05). O grupo SN6AD1 obteve valor de 0,04 logMAR e o grupo ZMB00 de 0,09 logMAR para DCNVA (p<0,05) e DCIVA de 0,17 logMAR para SN6AD1 e 0,54 logMAR para ZMB00 (p=0,000). Houve melhora do equivalente esférico e da UDVA em ambos os grupos (p<0,05). Em condições fotópicas, o grupo SN6AD1 teve melhor sensibilidade ao contraste em baixas frequências sem ofuscamento (p<0,05), contudo grupo ZMB00 obteve melhor sensibilidade em altas frequências (p<0,05) com ofuscamento. As lentes SN6AD1 e ZMB00 obtiveram comportamento semelhantes para visão intermediária na curva de Defocus, porém, o grupo ZMB00 mostrou menor distância de leitura que o grupo SN6AD1. Não houve diferença com significância estatística relacionada à aberrometria na comparação dos dois grupos. Conclusão: As duas lentes promoveram melhor qualidade de visão para longe e perto e comportamento semelhante para visão intermediária. O grupo ZMB00 exibiu melhores resultados para sensibilidade ao contraste em condições fotópicas em alta frequência espacial e SN6AD1 em baixa frequência espacial.

Assuntos

Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Acuidade Visual/fisiologia , Implante de Lente Intraocular/métodos , Lentes Intraoculares , Período Pós-Operatório , Desenho de Prótese , Valores de Referência , Refração Ocular , Análise de Variância , Resultado do Tratamento , Aberrometria , Período Pré-Operatório

RESUMO

PURPOSE: To compare the efficiency of surgical procedures using three phaco tip designs in torsional phacoemulsification using the bevel-down technique. METHODS: In this prospective, comparative, masked study, patients were randomly assigned to have torsional coaxial microincision cataract surgery using the mini-flared 45-degree Kelman tip, reversed mini-flared 30-degree Kelman tip, or Sidewinder 30-degree Kelman tip. Clinical measurements included preoperative and 3-month postoperative corrected distance visual acuity (CDVA), endothelial cell counts (ECC), and preoperative and 1-day postoperative central corneal thickness (CCT). Intraoperative measurements included phaco time, torsional time, aspiration time, case time, cumulative dissipated energy (CDE), and balanced salt solution volume (BSS). RESULTS: The study evaluated 150 eyes of 150 patients. Intraoperatively, there was no statistically significant difference in cumulative dissipated energy, case time, torsional time, and aspiration time between the three tip configurations. However, less phaco time was used with the mini-flared 45-degree Kelman tip (p=0.02) than that with the Sidewinder 30-degree Kelman tip or reversed mini-flared 30-degree Kelman tip. The mini-flared 45-degree Kelman tip and the reversed mini-flared 30-degree Kelman tip required significantly less balanced salt solution volume than that required by the Sidewinder 30-degree Kelman tip (p=0.009). There was no statistically significant difference in corrected distance visual acuity and endothelial cell counts between tips 3 months postoperatively (p>0.05). CONCLUSION: All three tips were effective with no intraoperative complications. When using torsional phacoemulsification through microincisions and the prefracture technique with the bevel-down technique, the mini-flared 45-degree Kelman tip required a lower mean phaco time than the reversed mini-flared 30-degree Kelman tip and the Sidewinder 30-degree Kelman tip.

Assuntos

Córnea/cirurgia , Facoemulsificação/instrumentação , Idoso , Idoso de 80 Anos ou mais , Contagem de Células , Endotélio Corneano/citologia , Desenho de Equipamento , Feminino , Humanos , Período Intraoperatório , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Facoemulsificação/métodos , Período Pós-Operatório , Cuidados Pré-Operatórios , Estudos Prospectivos , Método Simples-Cego , Resultado do Tratamento , Acuidade Visual/fisiologia

RESUMO

Purpose: To compare the efficiency of surgical procedures using three phaco tip designs in torsional phacoemulsification using the bevel-down technique. Methods: In this prospective, comparative, masked study, patients were randomly assigned to have torsional coaxial microincision cataract surgery using the mini-flared 45-degree Kelman tip, reversed mini-flared 30-degree Kelman tip, or Sidewinder 30-degree Kelman tip. Clinical measurements included preoperative and 3-month postoperative corrected distance visual acuity (CDVA), endothelial cell counts (ECC), and preoperative and 1-day postoperative central corneal thickness (CCT). Intraoperative measurements included phaco time, torsional time, aspiration time, case time, cumulative dissipated energy (CDE), and balanced salt solution volume (BSS). Results: The study evaluated 150 eyes of 150 patients. Intraoperatively, there was no statistically significant difference in cumulative dissipated energy, case time, torsional time, and aspiration time between the three tip configurations. However, less phaco time was used with the mini-flared 45-degree Kelman tip (p=0.02) than that with the Sidewinder 30-degree Kelman tip or reversed mini-flared 30-degree Kelman tip. The mini-flared 45-degree Kelman tip and the reversed mini-flared 30-degree Kelman tip required significantly less balanced salt solution volume than that required by the Sidewinder 30-degree Kelman tip (p=0.009). There was no statistically significant difference in corrected distance visual acuity and endothelial cell counts between tips 3 months postoperatively (p>0.05). Conclusion: All three tips were effective with no intraoperative complications. When using torsional phacoemulsification through microincisions and the prefracture technique with the bevel-down technique, the mini-flared 45-degree Kelman tip required a lower mean phaco time than the reversed mini-flared 30-degree Kelman tip and the Sidewinder 30-degree Kelman tip. .

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Objetivo: Comparar a eficácia cirúrgica da facoemulsificação com tecnologia torcional utilizando 3 modelos diferentes de ponteiras. Métodos: Neste estudo prospectivo, randomizado, mascarado, os pacientes foram aleatoriamente distribuídos para serem submetidos a cirurgia de facoemulsificação coaxial torcional utilizando a ponteira Kelman mini-flared de 45 graus, ou Kelman reversed mini-flared de 30 graus ou Kelman Sidewinder de 30 graus. Os parâmetros avaliados incluíram: acuidade visual com correção (AVCC) para longe; contagem de células endoteliais (CCE) pré-operatória e pós-operatória, ao final de 3 meses; espessura corneana central (ECC) pré-operatória e no primeiro dia pós-operatório. Medidas intraoperatórias incluíram tempo de facoemulsificação, tempo de energia torcional, tempo da aspiração, tempo cirúrgico, energia dissipada acumulada (CDE) e volume de solução salina balanceada (BSS). Resultados: Este estudo avaliou 150 olhos de 150 pacientes. No intraoperatório, não foram observadas diferenças significativas na energia dissipada acumulada, tempo de facoemulsificação, tempo de energia torcional, e tempo de aspiração entre os 3 modelos de ponteira. No entanto, foi utilizando menos tempo de faco com a ponteira Kelman mini-flared de 45 graus (p=0,02) quando comparado às ponteiras Kelman Sidewinder de 30 graus e reversa mini-flared de 30 graus. A ponteira Kelman mini-flared de 45 graus e a reversa mini-flared de 30 graus utilizaram menos solução salina balanceada quando comparado à ponteira Sidewinder de 30 graus (p=0,009). Não foram observadas diferenças significativas na acuidade visual com correção, contagem de células endoteliais e espessura corneana central entre as diferentes ponteiras ao final do estudo (p=0,05). Conclusão: As 3 ponteiras foram eficazes e não apresentaram complicacões intraoperatórias. Quando foi utilizando o faco torcional através de microincisão com a técnica da pré-fratura, a ponteira Kelman mini-flared ...

Assuntos

Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Córnea/cirurgia , Facoemulsificação/instrumentação , Contagem de Células , Desenho de Equipamento , Endotélio Corneano/citologia , Período Intraoperatório , Duração da Cirurgia , Período Pós-Operatório , Cuidados Pré-Operatórios , Estudos Prospectivos , Facoemulsificação/métodos , Método Simples-Cego , Resultado do Tratamento , Acuidade Visual/fisiologia

RESUMO

PURPOSE: To compare the anti-inflammatory efficacy of ketorolac of tromethamine 0.4% and nepafenac 0.1% eye drops for prophylaxis of cystoid macular oedema (CME) after small-incision cataract extraction. METHODS: Patients were assigned randomly to three groups. Group 1 patients received a topical artificial tear substitute (placebo); group 2 received ketorolac tromethamine 0.4% (Acular LS, Allergan) and group 3 received nepafenac 0.1% (Nevanac, Alcon). The incidence and severity of CME were evaluated by retinal foveal thickness on optical coherence tomography (OCT) after 1, 4 and 12 weeks. RESULTS: One hundred and twenty-six eyes of 126 patients were included in this study. The between-group differences in visual outcomes, central corneal thickness and endothelial cell density were not statistically significant. In all retinal thickness measurements, an increase was detected starting from the postoperative first week until 12 weeks. There was no statistically significant difference between the three groups in any measurement performed by spectral-domain OCT. CONCLUSIONS: Used prophylactically after uneventful cataract surgery, non-steroidal anti-inflammatory drugs were not efficacious in preventing macular oedema compared with placebo. TRIAL REGISTRATION NUMBER: ClinicalTrials: NCT02084576.

Assuntos

Anti-Inflamatórios não Esteroides/uso terapêutico , Benzenoacetamidas/uso terapêutico , Cetorolaco/uso terapêutico , Edema Macular/prevenção & controle , Facoemulsificação , Fenilacetatos/uso terapêutico , Complicações Pós-Operatórias/prevenção & controle , Administração Tópica , Idoso , Idoso de 80 Anos ou mais , Anti-Inflamatórios não Esteroides/administração & dosagem , Benzenoacetamidas/administração & dosagem , Feminino , Humanos , Cetorolaco/administração & dosagem , Implante de Lente Intraocular , Edema Macular/diagnóstico , Masculino , Pessoa de Meia-Idade , Soluções Oftálmicas , Fenilacetatos/administração & dosagem , Complicações Pós-Operatórias/diagnóstico , Estudos Prospectivos , Refração Ocular/fisiologia , Retina/patologia , Tomografia de Coerência Óptica , Acuidade Visual/fisiologia

RESUMO

Objetivo: Medir e comparar o tamanho e forma de capsulotomias realizadas com laser de femtossegundo com os de capsulorrexes curvilíneas contínuas (CCC) realizadas com auxilio guiado por imagem digital e avaliar o resultado refracional. Métodos: Durante cirurgia de catarata, 40 olhos de 40 pacientes tiveram a capsulotomia realizada com auxílio do laser de femtossegundo e seus resultados foram comparados com os de 40 olhos de 40 outros pacientes que tiveram a capsulorrexe guiada por sistema de imagem digital. Os parâmetros de circularidade, forma e overlap foram medidos usando o Adobe Photoshop (Adobe Systems Inc.) e os resultados refracionais pós-operatórios foram avaliados em ambos os grupos. Resultados: Os diâmetros, tamanho e forma de alta precisão e previsibilidade foram atingidos com laser de femtossegundo e houve diferença estatística entre os grupos. Quando comparado o equivalente esférico entre os grupos, não houve diferença estatística. Conclusão: As capsulotomias realizadas pelo laser de femtossegundo possuem circularidade programada, diâmetro pretendido e valores de desvio padrão médios, indicando resultados reprodutíveis mais elevados. No entanto, CCC realizada por um cirurgião experiente com auxílio guiado de imagem digital, com configurações apropriadas, fornece resultados semelhantes e sugere que diferentes técnicas são igualmente eficazes. .

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Purpose: To measure and compare size and shape parameters of femtosecond laser capsulotomy with manually continuous curvilinear digital guided capsulorhexis (CCC) and their refractive outcomes. Methods: Laser capsulotomies in 40 eyes of 40 patients were performed using LenSx femtosecond laser device (Alcon, Forthworth, US) and its results were compared with the CCC digital guided carried out in 40 eyes of 40 patients using the Callisto Eye digital image system (Zeiss, Germany). Capsulorhexis circularity, shape and capsule overlap were measured using Adobe Photoshop (Adobe Systems Inc.) and postoperative refraction outcomes were evaluated in both groups. Results: Highly accurate and predictable capsulotomy diameter, size and shape were achieved with femtosecond laser capsulotomy compared with capsulorhexis and showed statistical difference between groups. Spherical equivalent comparison between groups showed no statistical difference. Conclusions: Femtosecond laser anterior capsulotomy with programed circularity had the intended diameter with average standard deviation values, indicating higher reproducible outcomes. Capsulorhexis performed by an experienced surgeon with auxiliary image guide and appropriate settings provides similar results our results suggest that different techniques are equally effective. .

Assuntos

Humanos , Idoso , Extração de Catarata/métodos , Facoemulsificação/métodos , Capsulorrexe/métodos , Terapia a Laser/instrumentação , Terapia a Laser/métodos , Capsulotomia Posterior/métodos , Estudo Comparativo , Microscopia Eletrônica de Varredura , Estudos Prospectivos , Implante de Lente Intraocular , Cápsula Anterior do Cristalino/cirurgia

RESUMO

PURPOSE: To assess the postoperative outcomes of a novel toric multifocal in traocular lens (IOL) in patients with cataract and corneal astigmatism. METHODS: This prospective nonrandomized study included patients with cataract, corneal astigmatism, and a motivation for spectacle independence. In all patients, a Rayner M-flex® T toric IOL was implanted in the capsular bag. Three months after surgery, the distance, intermediate, and near visual acuities; spherical equivalent; residual refractive astigmatism; defocus curve; and contrast sensitivity were evaluated. A patient satisfaction and visual phenomena questionnaire was administered to all patients. RESULTS: Thirty-four eyes of 18 patients were included in this study. Three months after surgery, the mean corrected distance visual acuity (logMAR) was 0.00 ± 0.08 at 6 m, 0.20 ± 0.09 at 70 cm, and 0.08 ± 0.11 at 40 cm. Uncorrected distance vision acuity was 20/40 or better in 100% eyes. The preoperative mean refractive cylinder (RC) was -2.19 (SD: ± 0.53). After a 3-month follow-up, the average RC was -0.44 D (SD: ± 0.27; p<0.001). Contrast sensitivity levels were high. At the last follow-up, 87.5% patients were spectacle-independent for near, intermediate, and distance vision, and approximately 44% patients reported halos and glare. CONCLUSION: Toric multifocal IOL implantation in patients with cataract and corneal astigmatism using the Rayner M-flex® T toric IOL was a simple, safe, and accurate option. This technology provides surgeons with a feasible option for meeting patient expectations of an enhanced lifestyle resulting from decreased spectacle dependence.

Assuntos

Astigmatismo/cirurgia , Extração de Catarata/métodos , Catarata/complicações , Implante de Lente Intraocular/métodos , Lentes Intraoculares , Idoso , Astigmatismo/complicações , Catarata/fisiopatologia , Sensibilidades de Contraste/fisiologia , Feminino , Humanos , Masculino , Satisfação do Paciente , Estudos Prospectivos , Resultado do Tratamento , Acuidade Visual/fisiologia

RESUMO

Purpose: To assess the postoperative outcomes of a novel toric multifocal in traocular lens (IOL) in patients with cataract and corneal astigmatism. Methods: This prospective nonrandomized study included patients with cataract, corneal astigmatism, and a motivation for spectacle independence. In all patients, a Rayner M-flex® T toric IOL was implanted in the capsular bag. Three months after surgery, the distance, intermediate, and near visual acuities; spherical equivalent; residual refractive astigmatism; defocus curve; and contrast sensitivity were evaluated. A patient satisfaction and visual phenomena questionnaire was administered to all patients. Results: Thirty-four eyes of 18 patients were included in this study. Three months after surgery, the mean corrected distance visual acuity (logMAR) was 0.00 ± 0.08 at 6 m, 0.20 ± 0.09 at 70 cm, and 0.08 ± 0.11 at 40 cm. Uncorrected distance vision acuity was 20/40 or better in 100% eyes. The preoperative mean refractive cylinder (RC) was -2.19 (SD: ± 0.53). After a 3-month follow-up, the average RC was -0.44 D (SD: ± 0.27; p<0.001). Contrast sensitivity levels were high. At the last follow-up, 87.5% patients were spectacle-independent for near, intermediate, and distance vision, and approximately 44% patients reported halos and glare. Conclusion: Toric multifocal IOL implantation in patients with cataract and corneal astigmatism using the Rayner M-flex® T toric IOL was a simple, safe, and accurate option. This technology provides surgeons with a feasible option for meeting patient expectations of an enhanced lifestyle resulting from decreased spectacle dependence. .

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Objetivo: Avaliar o resultado pós-operatório de uma nova lente intraocular (LIO) multifocal tórica implantada em pacientes com catarata e astigmatismo corneano. Métodos: Estudo prospectivo não randomizado envolvendo pacientes com catarata, astigmatismo corneano, e motivação para eliminar a dependência dos óculos. Em todos os casos, a lente intraocular tórica Rayner M-flex® T foi implantada dentro do saco capsular. Três meses pós-operatório foram avaliados: acuidade visual para longe, intermediário e perto; equivalente esférico; astigmatismo refracional residual; curva de defocus e sensibilidade ao contraste. Ao final do estudo um questionário referente à satisfação visual foi aplicado. Resultados: Trinta e quatro olhos de 18 pacientes foram incluídos no estudo. Após 3 meses de pós-operatório, a acuidade visual corrigida para longe (logMAR) era de 0,00 ± 0,08 a 6 m, 0,20 ± 0,09 a 70 cm e 0,08 ± 0,11 a 40 cm. A acuidade visual sem correcão foi de 20/40, ou melhor, em 100% dos olhos. A média do cilindro refracional pré-operatório era de -2,19 (DP: ± 0,53). Após o seguimento de 3 meses a média do cilindro refracional era de -0,44 D (DP: ± 0,27) (p<0,001). Os níveis de sensibilidade ao contraste foram elevados. Ao final do seguimento, 87,5% dos pacientes estavam independentes dos óculos para perto, intermediário e para longe, e aproximadamente 44% dos pacientes relatavam halos e glare. Conclusão: O implante de uma lente intraocular multifocal em pacientes com catarata e astigmatismo corneano utilizando a lente intraocular tórica Rayner M-flex® T foi uma opção simples, segura e acurada. Essa nova tecnologia oferece ao cirurgião uma maneira passível de se atingir as expectativas dos pacientes em relação ...

Assuntos

Idoso , Feminino , Humanos , Masculino , Astigmatismo/cirurgia , Extração de Catarata/métodos , Catarata/complicações , Lentes Intraoculares , Implante de Lente Intraocular/métodos , Astigmatismo/complicações , Catarata/fisiopatologia , Sensibilidades de Contraste/fisiologia , Satisfação do Paciente , Estudos Prospectivos , Resultado do Tratamento , Acuidade Visual/fisiologia

RESUMO

OBJETIVO: Elaborar e validar o questionário de qualidade de vida na versão do idioma português. MÉTODOS: O questionário "Cataract TyPESpecification" modificado foi desenvolvido especificamente para avaliar a qualidade de vida pós-cirurgia de catarata. O questionário avaliou 10 itens status funcionais por meio de 18 perguntas. Foi aplicado por um único examinador, com o objetivo de graduar a satisfação visual de 0 a 10 (0 muito insatisfeito; 5 neutro; 10 muito satisfeito). Houve estudo prospectivo comparativo, não randomizado, que incluiu 142 olhos de 71 pacientes com catarata da Universidade de São Paulo. A avaliação oftalmológica contou com medida da acuidade visual para longa, intermediária e curta distâncias, sem correção e com a melhor correção óptica e questionário de satisfação. Foi submetido a um questionário de satisfação quanto à acuidade visual e fenômenos fóticos. Todos os exames foram realizados com 6 meses de pós-operatório. RESULTADOS: A média de idade dos pacientes foi de 60,7 ± 6,6 anos no grupo Tecnis, 63,1 ± 4,4 anos no grupo Restor e 63,7 ± 4,2 anos no grupo SN60AT/SN60WF. A acuidade visual para perto não-corrigida e a corrigida para longe foram estatisticamente superiores nos grupos Restor® e Tecnis® comparadas ao grupo SN60AT/SN60WF (p<0,001). Não houve diferença estatística entre os grupos quando comparadas a acuidade visual para longe não-corrigida e a melhor corrigida (p=0,56). O questionário de satisfação apresentou maior independência de óculos a favor da Tecnis® (9,3/10) e Restor® (8,7/10), mas com mais queixas de halos (Restor® 18,8%; Tecnis® 21,7%) e glare (Restor® 25%; Tecnis® 26,1%) do que no grupo SN60AT/SN60WF. CONCLUSÃO: A Restor® e Tecnis® apresentaram melhor acuidade visual para perto do que o grupo SN60AT/SN60WF. As lentes Restor® e Tecnis® apresentaram maior satisfação na visão de perto e independência do uso de óculos e fenômenos fóticos do que as lentes monofocais...

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PURPOSE: Development and validation of quality of life questionnaire in pseudophakic patients in Portuguese. METHODS: The modified Cataract TyPESpecification questionnaire was specifically developed to assess quality of life after cataract surgery, functional status evaluated with 10 items and contains 18 questions. All questions were applied by a single examiner, with the goal of graduating visual satisfaction from 0 to 10 (0 means very dissatisfied, 5 neutral, 10 very satisfied).This prospective comparative study included 142 eyes of 71 patients in Sao Paulo University. The ophthalmologic evaluation performed included near, intermediate and distance corrected and uncorrected visual acuity and quality of life questionaire. The minimum follow-up was 6 months. RESULTS: The mean age of patients was 60.7± 6.6 years in theTecnis®MF, 63.1 ±4.4 years in-groupRestor®63.7±4.2 years in-group SN60AT/SN60WF. Uncorrected and distance-corrected near visual acuity were statistically higher in theRestor® and Tecnis® groups compared to the SN60AT/SN60WF group (p<0.001). There were no statistical differences between groups comparing uncorrected and best-corrected distance visual acuity (p=0.56). Satisfaction questionnaire showed high glasses independence fortheTecnis®MF (9.3 /10) and Restor® (8.7 /10), but with more unsatisfied of halos (18.8% Restor®, Tecnis®21, 7%) and glare (Restor® 25%;Tecnis®26.1%) than the group SN60AT/SN60WF. CONCLUSION: Cataract patients who received multifocal (Restor®; Tecnis®MF) IOLs at time of surgery obtained better uncorrected and distance corrected near visual acuity and reported better overall vision, less limitation in visual function, less spectacle dependency, and more glare or halo than those who received monofocal (SN60AT; SN60WF) IOLs. Cataract TyPESpecification questionnaire was a strong predictor of change in patient satisfaction caused by cataract surgery.

Assuntos

Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Extração de Catarata , Implante de Lente Intraocular , Satisfação do Paciente , Qualidade de Vida , Acuidade Visual , Estudos Prospectivos , Inquéritos e Questionários

RESUMO

OBJETIVO: Comparar a performance visual dos pacientes submetidos ao implante das lentes intraoculares multifocais difrativas Tecnis® MF ZM900, Acrysof® Restor® SN60D3, Acrysof® SN60WF e Acrysof® SN60AT. MÉTODOS: Estudo prospectivo comparativo, não randomizado, que incluiu 142 olhos de 71 pacientes com catarata, provenientes do ambulatório de oftalmologia do HC-FMUSP. A avaliação oftalmológica contou com medida da acuidade visual para longa, intermediária e curta distância, sem correção e com a melhor correção óptica, teste de sensibilidade ao contraste, pupilometria e análise de frente de onda por meio do aberrômetro. Todos os exames foram realizados com seis meses de pós-operatório. RESULTADOS: A média de idade dos pacientes foi de 60,7±6,6 anos no grupo Tecnis, 63,1±4,4 anos no grupo Restor e 63,7±4,2 anos no grupo monofocal (SN60AT no olho contralateral SN60WF). A acuidade visual para perto não corrigida e corrigida para longe foi estatisticamente superior nos grupos multifocal Restor e multifocal Tecnis em comparação ao grupo monofocal SN60AT/SN60WF (p<0,001). Não houve diferença estatística entre os grupos na comparação da acuidade visual para longe (p=0,56). A sensibilidade ao contraste fotópica monocular foi estatisticamente inferior nos grupos Restor e Tecnis (p<0,001). A SN60AT apresentou maior aberração esférica comparada a todas as outras lentes (p<0,001). A Tecnis se mostrou com menores valores médios de aberrações esféricas na comparação com a Restor (p<0.001). CONCLUSÃO: A Restor e Tecnis apresentaram melhor acuidade visual para perto do que o grupo monofocal SN60AT/SN60WF. Todas as lentes intraoculares promoveram boa visão para longe. O grupo da Tecnis apresentou melhor sensibilidade de contraste, menos aberrações ópticas e melhor visão intermediária que o grupo Restor.

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OBJECTIVE: Comparison of the visual performance between patients with Tecnis® MF ZM900, Acrysof® Restor® SN60D3, Acrysof® SN60AT and Acrysof® SN60WF intraocular lenses. METHODS: This prospective comparative study included 142 eyes of 71 patients in Sao Paulo University. The ophthalmologic evaluation performed included near, intermediate and distance corrected and uncorrected visual acuity, contrast sensitivity measurement and wavefront analysis. The minimum follow-up was 6 months. RESULTS: The mean age of patients was 60.7±6.6years in the Tecnis®MF, 63.1±4.4 years in-group Restor® 63.7±4.2 years in monofocal group (SN60AT in the fellow eye SN60WF). The Restor and Tecnis groups has uncorrected near and corrected distance visual acuity statistically superior compared to SN60AT/SN60WF group (p<0.001). There was no statistical difference between groups when compared uncorrected and best-corrected distance visual acuity (p=0.56). Contrast sensitivity in photopic conditions was significantly lower in the Restor and Tecnis group (p<0.001). The SN60AT showed higher spherical aberration compared to all other lenses (p<0.001). The Tecnis showed a lower mean values of spherical aberration compared to Restor lenses (p<0.001). CONCLUSION: Restor and the Tecnis had better near visual acuity than the SN60AT/SN60WF group. All intraocular lenses promoted good distance vision. The Tecnis group showed better contrast sensitivity, less aberrations and better intermediate vision than the Restor group.

Assuntos

Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Catarata , Lentes Intraoculares , Satisfação do Paciente , Pseudofacia , Estudos Prospectivos

RESUMO

A 51-year-old woman with age-related cataract had an uneventful phacoemulsification and a Tecnis ZM900 multifocal intraocular lens (IOL) implantation in both eyes. During IOL implantation in the left eye, the optic was unintentionally reversed in the bag and left that way. The refraction surprise was not significant and six months postoperatively the corrected distance visual acuity in both eyes was 20/20 and neither complained of visual discomfort. In conclusion, we found that a reversed-optic Tecnis multifocal IOL in the present case resulted in good final visual acuity without significant differences in aberrations compared to the other eye, and a conservative management can be taken as a safe option.

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Paciente de 51 anos, sexo feminino, apresentando catarata foi submetida a cirurgia de facoemulsificação com implante de lente intraocular (LIO) multifocal Tecnis ZM900 em ambos os olhos (AO). Durante a implantação da LIO no olho esquerdo, a lente foi inadvertidamente implantada invertida e deixada dessa maneira. Seis meses pós-operatório a surpresa refracional não se mostrou significativa e a acuidade visual corrigida era de 20/20 em AO, sem nenhuma queixa de desconforto visual. Em conclusão, no presente caso, o implante de uma LIO Tecnis multifocal invertida resultou em boa acuidade visual final e sem diferenças significativas na aberrometria em comparação ao olho contralateral, tendo sido possível conduzir o caso de maneira conservadora.

Assuntos

Feminino , Humanos , Pessoa de Meia-Idade , Implante de Lente Intraocular/efeitos adversos , Facoemulsificação , Catarata/complicações , Implante de Lente Intraocular/métodos , Erros Médicos , Acuidade Visual

RESUMO

A 51-year-old woman with age-related cataract had an uneventful phacoemulsification and a Tecnis ZM900 multifocal intraocular lens (IOL) implantation in both eyes. During IOL implantation in the left eye, the optic was unintentionally reversed in the bag and left that way. The refraction surprise was not significant and six months postoperatively the corrected distance visual acuity in both eyes was 20/20 and neither complained of visual discomfort. In conclusion, we found that a reversed-optic Tecnis multifocal IOL in the present case resulted in good final visual acuity without significant differences in aberrations compared to the other eye, and a conservative management can be taken as a safe option.

Assuntos

Implante de Lente Intraocular/efeitos adversos , Facoemulsificação , Catarata/complicações , Feminino , Humanos , Implante de Lente Intraocular/métodos , Erros Médicos , Pessoa de Meia-Idade , Acuidade Visual

RESUMO

PURPOSE: To compare the visual outcome, contrast sensitivity and wavefront analysis of patients that underwent cataract surgery and implantation of AcrySof SN60D3 multifocal intraocular lens with those who received the AcrySof SN60AT monofocal IOL. METHODS: This was a prospective clinical trial of forty eyes that received the multifocal IOL and thirty-two eyes that received the monofocal IOL after phacoemulsification. RESULTS: Values for total and spherical aberrations in the multifocal group were statistically lower than in the monofocal group. In the monofocal group, 75% achieved uncorrected intermediate visual acuities between Jaeger 1 and 6. In the multifocal group, 75% of the eyes achieved more than Jaeger 6. At least 87.5% of the multifocal group and 6.3% of the monofocal group achieved monocular uncorrected near acuity of 20/30 (J2, N5) or better. And 90.0% of the eyes in the multifocal group and 37.5% in the monofocal group achieved an uncorrected near acuity of 20/40 (J3, N6) or better. The mean spherical error was 0.11 D in the multifocal group and -0.18 D in the monofocal group (p=0.0379). The SN60D3 group compared to SN60AT group had low contrast sensitivity (log units) with statistically significant differences in 6.0 cpd in photopic conditions (p=0.014) and the SN60D3 group compared to SN60AT group had higher contrast sensitivity (log units) under mesopic conditions (p=0.044). CONCLUSION: The multifocal IOLs induced less spherical aberration than monofocal IOLs and predictably good uncorrected distance and uncorrected near acuities. However, contrast sensitivity was lower in the multifocal group.

Assuntos

Sensibilidades de Contraste , Implante de Lente Intraocular , Facoemulsificação/métodos , Acuidade Visual , Idoso , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos , Resultado do Tratamento

RESUMO

Purpose: Compare the OPD-scan results and the contrast sensitivity in patients who had implantation of the AcrySof SN60D3 multifocal IOL, the AcrySof SA60AT spheric monofocal IOL and the AcrySof SN60AT aspheric monofocal IOL. Methods: Thirty-two eyes received the multifocal IOL, 32 eyes received the spheric monofocal IOL and 32 eyes received the aspheric monofocal IOL. They were closely paired in age, sex, pre-operative wavefront analysis and contrast sensitivity. All patients was tested with the OPD-scan aberrometer, ETDRS chart at 100 percent and 9% contrasts and contrast sensitivity. Results: Statistically significant differences were detected more total aberration in SN60AT group (KW = 9.42; p=0.009) when compared to SN60D3 group (p=0.016) and SN60WF group (p=0.0047). The SN60AT group (KW = 16.20; p=0.0003) showed with high spherical aberration values compared to the SN60WF (p=0.00046) and SN60D3 (p=0.0014) group. No significant differences were found between groups in far-distance VA measured using ETDRS at 100% and 9% contrast. The SN60D3 group compared to SN60AT group (p=0.016) had low contrast sensitivity (log units) with statistical difference in 6.0 cpd (KW = 7.84; p=0.0199), but no statistical difference between SN60WF and SN60AT group (p=0.91) and SN60WF and SN60D3 group (p=0.051). The SN60D3 group had low contrast sensitivity performed under mesopic conditions (KW = 10.79; p=0,0045) in 6cpd spatial frequency compared to the SN60AT group (p=0.011) and to the SN60WF group (p=0.007) with statistical significant differences. Conclusion: In all analyzed parameters of OPD-scan aberrometry the aspheric and the multifocal IOLs provided less total and spherical aberrations than spheric IOLs. All IOLs provided an excellent high and low contrasts vision, the multifocal IOL was as good as the spheric and aspheric monofocal IOLs.

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Objetivo: Comparar a sensibilidade ao contraste e análise de "wavefront" com OPD-scan em pacientes submetidos a cirurgia de facoemulsificação com implantes de lentes intraoculares AcrySof SN60D3 multifocal, AcrySof SN60WF monofocal asférica e AcrySof SA60AT monofocal esférica. Métodos: Trinta e dois olhos com a lente intraocular multifocal, 32 olhos com a lente intraocular monofocal asférica e 32 olhos com a lente intraocular monofocal esférica. A avaliação oftalmológica foi realizada no primeiro, terceiro, sétimo, e nonagésimo dia pós-operatório. Todos os exames foram padronizados, realizada por um único examinador sob condições controladas de luminosidade fotópicas estabelecidas em 85 cd/m², medida por meio de tabelas de ETDRS, sensibilidade ao contraste e análise de aberrometria com OPD-Scan. Resultados: As médias de aberração total foi superior no grupo SN60AT (KW = 9.42; p=0.009) quando comparada com o grupo SN60D3 (p=0.016) e o grupo SN60WF (p=0.0047). O grupo SN60AT (KW = 16.20; p=0.0003) apresentou superioridade nas medias de aberração esférica comparada com o grupo SN60WF (p=0.00046) e o grupo SN60D3 (p=0.0014). Nenhuma diferença significante foi encontrada na acuidade visual para longe com e sem correção óptica com a tabela de ETDRS a 100% e 9% de contraste. O grupo SN60D3 comparada a SN60AT (p=0.016) apresentou baixa sensibilidade ao contraste em condições fotópicas com diferença estatística a 6.0 cpg (KW = 7.84; p=0.0199), mas sem diferença estatística entre os grupos SN60WF e SN60AT (p=0.91) e entre os grupos SN60WF e SN60D3 (p=0.051). O grupo SN60D3 apresentou baixa sensibilidade ao contraste em condições mesópicas (KW = 10.79; p=0,0045) a 6cpg quando comparada com o grupos SN60AT (p=0.011) e SN60WF (p=0.007). Conclusão: As lentes intraoculares multifocais e asféricas apresentaram menos aberração esférica quando comparadas à lente intraocular esférica, além da prevista multifocalidade sem correção para ...

Assuntos

Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Sensibilidades de Contraste , Lentes , Lentes Intraoculares , Facoemulsificação , Acuidade Visual , Estudos Retrospectivos

RESUMO

PURPOSE: To compare the visual outcome, contrast sensitivity and wavefront analysis of patients that underwent cataract surgery and implantation of AcrySof SN60D3 multifocal intraocular lens with those who received the AcrySof SN60AT monofocal IOL. METHODS: This was a prospective clinical trial of forty eyes that received the multifocal IOL and thirty-two eyes that received the monofocal IOL after phacoemulsification. RESULTS: Values for total and spherical aberrations in the multifocal group were statistically lower than in the monofocal group. In the monofocal group, 75 percent achieved uncorrected intermediate visual acuities between Jaeger 1 and 6. In the multifocal group, 75 percent of the eyes achieved more than Jaeger 6. At least 87.5 percent of the multifocal group and 6.3 percent of the monofocal group achieved monocular uncorrected near acuity of 20/30 (J2, N5) or better. And 90.0 percent of the eyes in the multifocal group and 37.5 percent in the monofocal group achieved an uncorrected near acuity of 20/40 (J3, N6) or better. The mean spherical error was 0.11 D in the multifocal group and -0.18 D in the monofocal group (p=0.0379). The SN60D3 group compared to SN60AT group had low contrast sensitivity (log units) with statistically significant differences in 6.0 cpd in photopic conditions (p=0.014) and the SN60D3 group compared to SN60AT group had higher contrast sensitivity (log units) under mesopic conditions (p=0.044). CONCLUSION: The multifocal IOLs induced less spherical aberration than monofocal IOLs and predictably good uncorrected distance and uncorrected near acuities. However, contrast sensitivity was lower in the multifocal group.

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OBJETIVO: Comparar a performance visual, sensibilidade ao contraste e de wavefront com OPD-Scan em pacientes submetidos a cirurgia de facoemulsificação com implante de lente intraocular AcrySof SN60D3 multifocal e AcrySof SA60AT monofocal. MÉTODOS: Quarenta olhos com a lente intraocular multifocal e trinta e dois olhos com a lente intraocular monofocal. A avaliação oftalmológica contou com medida da acuidade visual para longe, intermediária e curta distância, sem correção e com a melhor correção óptica, teste de sensibilidade ao contraste e análise de frente de onda por meio do aberrômetro OPD-Scan. RESULTADOS: As aberração total e aberração esférica no grupo multifocal foi estatisticamente inferior comparada com o grupo monofocal. No grupo monofocal 75 por cento apresentaram acuidade visual monocular intermediária sem correção entre Jaeger 1 e 6, no grupo multifocal 75 por cento apresentaram mais que Jaeger 6. Aproximadamente 87,5 por cento do grupo multifocal e 6,3 por cento do grupo monofocal apresentaram acuidade visual monocular sem correção para perto de 20/30 (J2, N5), ou melhor, e 90,0 por cento dos olhos do grupo multifocal e 37,5 por cento do grupo monofocal apresentaram acuidade visual monocular sem correção para perto de 20/40 (J3, N6) ou melhor. A média de erro esférico foi de 0,11 D no grupo multifocal e -0,18 D no grupo monofocal (p=0,0379). O grupo monofocal apresentou superioridade estatística na sensibilidade ao contraste em condições fotópicas (p=0,014) e mesópicas (p=0,0044) a 6 cpg quando comparada ao grupo multifocal. CONCLUSÃO: A lente intraocular multifocal apresentou menos aberração esférica comparada à lente intraocular monofocal, da prevista multifocalidade sem correção para longe e perto. Entretanto, o grupo multifocal apresentou baixa sensibilidade ao contraste.

Assuntos

Idoso , Humanos , Pessoa de Meia-Idade , Sensibilidades de Contraste , Implante de Lente Intraocular , Facoemulsificação/métodos , Acuidade Visual , Estudos Prospectivos , Resultado do Tratamento

RESUMO

PURPOSE: The aim of the present study is to assess central corneal edema and visual recovery after cataract surgery performed according to two technologies: conventional ultrasonic and liquefaction (Aqualase®). METHODS:This is a prospective contralateral study in wich 20 patients with comparable preoperative conditions were submitted to cataract surgery were evaluated. Preoperative assessment involved complete ophthalmological examination and the study included patients with bilateral cataracts up to grade 2, according to the Lens Opacity Classification System II. The same cristaline fracture technique was used in all cases, and surgical procedures were performed by the same experienced surgeon, using two technologies: liquefaction or conventional phacoemulsification. Postoperative central corneal edema was measured by corneal optical pachymetry (Orbscan II®) on the 1st, 3rd, 7th and 10th postoperative days. RESULTS:None of the 20 patients submitted to surgery was lost during the postoperative follow-up or excluded from the analysis. On the first postoperative, the visual acuity average was 0.031 logMAR in the Aqualase® group and 0.043 logMAR in the conventional surgery group. No statistical difference was detected in the assessment of visual acuity throughout the postoperative period. Central corneal pachymetry varied from 543.93 + 34.69 preoperatively to 545.08 ± 25.67 on the last day of follow-up in the Aqualase® group, and from 543.13 + 30.62 to 536.08 + 34.89 in the conventional technique group, without statistical significance. CONCLUSION:This study suggests that both techniques are equally effective for surgery on lenses with grade I or II cataract, and that they provide similar results in terms of visual recovery and central corneal edema.

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OBJETIVO: Avaliar o edema corneano central e a recuperação visual após cirurgia de catarata realizada através de duas tecnologias: ultrassônica convencional e liquefação (Aqualase®). MÉTODOS: Estudo retrospectivo com análise contralateral, onde 20 pacientes se submeteram à facectomia sob condições pré-operatórias comparáveis. A avaliação pré-operatória envolveu exame oftalmológico completo com graduação da catarata de acordo com o Lens Opacity Classification System II, e foram incluídos no estudo pacientes com catarata nuclear bilateral até grau II. A mesma técnica cirúrgica foi realizada em todos os casos pelo mesmo cirurgião, utilizando as duas tecnologias: liquefação e facoemulsificação convencional. As medidas do edema corneano pós-operatório foram realizadas com paquímetro óptico corneano (Orbscan II®) nos dias 1, 3, 7 e 10 de pós-operatório. RESULTADOS: Nenhum dos pacientes inicialmente inscritos no estudo foi excluído ou perdido durante o seguimento. No primeiro dia pós-operatório a acuidade visual média foi de 0.031 logMAR no grupo de Aqualase e 0.043 logMAR no grupo convencional. Nenhuma diferença estatisticamente significativa foi detectada na análise de acuidade visual durante o período pós-operatório. A paquimetria corneana central variou de 543.93 + 34.69 no pré-operatório para 545.08 ± 25.67 no último dia de acompanhamento no grupo de Aqualase e de 543.13 + 30.62 para 536.08 + 34.89 no grupo convencional, sem diferença estatisticamente significativa. CONCLUSÃO: O estudo sugere que as duas técnicas são igualmente eficaz para as cirurgias nucleares graus I e II, além de apresentarem resultados similares em relação ao edema corneano central e à recuperação visual.