Maximising Refractive Outcomes with an Extended Depth of Focus IOL

Barry Power, Rory Murphy, Antonio Leccisotti, Tara C. B. Moore, William Power, Paul O'Brien

Research output: Contribution to journalArticle

Abstract

Objective: To assess the impact of the magnitude of preoperative and postoperative corneal astigmatism on refractive outcomes in patients undergoing cataract surgery or lens exchange with an extended depth of focus intraocular lens. To compare visual outcomes of steep and temporal on-axis corneal incisions.

Setting: Department of Ophthalmology, Blackrock Clinic, Dublin, Ireland

Design: Prospective cohort analysis. 

Methods: Fifty-three consecutive adult patients (94 eyes) undergoing routine phacoemulsification with Symfony IOL implantation were analysed. Exclusion criteria: targets for mini-monovision, incomplete data, other ocular pathology. Data prospectively collected on pre- and postoperative refraction, keratometry, distance vision, near vision, surgical wound site and surgically induced astigmatism (SIA). 

Results: The average postoperative monocular uncorrected distance and near visual acuities (UDVA and UNVA) were 0.12 LogMAR (± 0.1) (6/7.5+1) and 0.34 LogMAR (± 0.09) respectively. The average binocular UDVA and UNVA were 0.05 (±0.07) and 0.29 LogMAR (±0.06) respectively. Low levels of preoperative corneal astigmatism (0-0.99 D) were associated with better LogMAR UDVA and UNVA when compared with higher levels (>0.99 D): 0.11 (CI 0.103-0.107) vs. 0.206 (CI 0.122-0.290) (p=0.015, CI 95%) and 0.33 (CI 0.316 - 0.356) vs. 0.39 (CI 0.34-0.43) (p=0.034, CI 95%) respectively. When patients with steep on-axis corneal incisions were compared with temporal on-axis corneal incisions, no difference was detected in visual outcome or SIA. 

Conclusion: The Symfony IOL is an effective surgical means of addressing presbyopia and reducing postoperative spectacle dependence. We stress caution when offering potential spectacle independence for patients with over 1D of preoperative corneal astigmatism as these patients achieve statistically significantly inferior and less predictable visual results.
LanguageEnglish
Article numberEA-TOOPHTJ-2018-20
Pages273-280
JournalOpen Ophthalmology Journal
DOIs
Publication statusPublished - 10 Sep 2018

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Astigmatism
Presbyopia
Phacoemulsification
Intraocular Lenses
Ophthalmology
Cataract
Lenses
Visual Acuity
Cohort Studies
Pathology

Keywords

  • Cataract Surgery
  • Corneal Astigmatism
  • Refractive Surgery
  • Symfony IOL
  • Extended Depth of Focus IOL

Cite this

Power, B., Murphy, R., Leccisotti, A., Moore, T. C. B., Power, W., & O'Brien, P. (2018). Maximising Refractive Outcomes with an Extended Depth of Focus IOL. 273-280. [EA-TOOPHTJ-2018-20]. https://doi.org/10.2174/1874364101812010273
Power, Barry ; Murphy, Rory ; Leccisotti, Antonio ; Moore, Tara C. B. ; Power, William ; O'Brien, Paul. / Maximising Refractive Outcomes with an Extended Depth of Focus IOL. 2018 ; pp. 273-280.
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Power, B, Murphy, R, Leccisotti, A, Moore, TCB, Power, W & O'Brien, P 2018, 'Maximising Refractive Outcomes with an Extended Depth of Focus IOL', pp. 273-280. https://doi.org/10.2174/1874364101812010273

Maximising Refractive Outcomes with an Extended Depth of Focus IOL. / Power, Barry; Murphy, Rory; Leccisotti, Antonio; Moore, Tara C. B.; Power, William; O'Brien, Paul.

10.09.2018, p. 273-280.

Research output: Contribution to journalArticle

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AU - Murphy, Rory

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N2 - Objective: To assess the impact of the magnitude of preoperative and postoperative corneal astigmatism on refractive outcomes in patients undergoing cataract surgery or lens exchange with an extended depth of focus intraocular lens. To compare visual outcomes of steep and temporal on-axis corneal incisions.Setting: Department of Ophthalmology, Blackrock Clinic, Dublin, IrelandDesign: Prospective cohort analysis. Methods: Fifty-three consecutive adult patients (94 eyes) undergoing routine phacoemulsification with Symfony IOL implantation were analysed. Exclusion criteria: targets for mini-monovision, incomplete data, other ocular pathology. Data prospectively collected on pre- and postoperative refraction, keratometry, distance vision, near vision, surgical wound site and surgically induced astigmatism (SIA). Results: The average postoperative monocular uncorrected distance and near visual acuities (UDVA and UNVA) were 0.12 LogMAR (± 0.1) (6/7.5+1) and 0.34 LogMAR (± 0.09) respectively. The average binocular UDVA and UNVA were 0.05 (±0.07) and 0.29 LogMAR (±0.06) respectively. Low levels of preoperative corneal astigmatism (0-0.99 D) were associated with better LogMAR UDVA and UNVA when compared with higher levels (>0.99 D): 0.11 (CI 0.103-0.107) vs. 0.206 (CI 0.122-0.290) (p=0.015, CI 95%) and 0.33 (CI 0.316 - 0.356) vs. 0.39 (CI 0.34-0.43) (p=0.034, CI 95%) respectively. When patients with steep on-axis corneal incisions were compared with temporal on-axis corneal incisions, no difference was detected in visual outcome or SIA. Conclusion: The Symfony IOL is an effective surgical means of addressing presbyopia and reducing postoperative spectacle dependence. We stress caution when offering potential spectacle independence for patients with over 1D of preoperative corneal astigmatism as these patients achieve statistically significantly inferior and less predictable visual results.

AB - Objective: To assess the impact of the magnitude of preoperative and postoperative corneal astigmatism on refractive outcomes in patients undergoing cataract surgery or lens exchange with an extended depth of focus intraocular lens. To compare visual outcomes of steep and temporal on-axis corneal incisions.Setting: Department of Ophthalmology, Blackrock Clinic, Dublin, IrelandDesign: Prospective cohort analysis. Methods: Fifty-three consecutive adult patients (94 eyes) undergoing routine phacoemulsification with Symfony IOL implantation were analysed. Exclusion criteria: targets for mini-monovision, incomplete data, other ocular pathology. Data prospectively collected on pre- and postoperative refraction, keratometry, distance vision, near vision, surgical wound site and surgically induced astigmatism (SIA). Results: The average postoperative monocular uncorrected distance and near visual acuities (UDVA and UNVA) were 0.12 LogMAR (± 0.1) (6/7.5+1) and 0.34 LogMAR (± 0.09) respectively. The average binocular UDVA and UNVA were 0.05 (±0.07) and 0.29 LogMAR (±0.06) respectively. Low levels of preoperative corneal astigmatism (0-0.99 D) were associated with better LogMAR UDVA and UNVA when compared with higher levels (>0.99 D): 0.11 (CI 0.103-0.107) vs. 0.206 (CI 0.122-0.290) (p=0.015, CI 95%) and 0.33 (CI 0.316 - 0.356) vs. 0.39 (CI 0.34-0.43) (p=0.034, CI 95%) respectively. When patients with steep on-axis corneal incisions were compared with temporal on-axis corneal incisions, no difference was detected in visual outcome or SIA. Conclusion: The Symfony IOL is an effective surgical means of addressing presbyopia and reducing postoperative spectacle dependence. We stress caution when offering potential spectacle independence for patients with over 1D of preoperative corneal astigmatism as these patients achieve statistically significantly inferior and less predictable visual results.

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Power B, Murphy R, Leccisotti A, Moore TCB, Power W, O'Brien P. Maximising Refractive Outcomes with an Extended Depth of Focus IOL. 2018 Sep 10;273-280. EA-TOOPHTJ-2018-20. https://doi.org/10.2174/1874364101812010273