Resultados de la encuesta NEI-RQL-42 en pacientes con catarata operados mediante facoemulsificación más implante de lente trifocal / Results of the NEI-RQL-42 survey in patients with cataract operated by phacoemulsifi cation and trifocal lens implant

Introducción: se encuentra reportado que a pesar de obtenerse buenos resultados de agudeza visual con los lentes multifocales, algunos pacientes no se encuentran a gusto con su visión; son pocos los artículos que describen de manera objetiva la satisfacción de los pacientes después del implante de éste tipo de lentes. Objetivo: describir los resultados de la encuesta NEI-RQL-42 en pacientes que han sido operados mediante facoemulsificación e implante de lente trifocal FineVision en ambos ojos. Diseño del estudio: estudio descriptivo de corte transversal. Método: se incluyeron pacientes operados de catarata e implante de lente trifocal FineVision en ambos ojos. Todos los pacientes fueron evaluados con Pentacam prequirúrgico y cumplieron con los criterios descritos por el doctor Maeda. Posteriormente se les aplicó la encuesta NEI-RQL-42 y se realizó una comparación de medias y proporciones, utilizando el programa SPSS, versión 19. Resultados: Los puntajes promedio para cada una de las categorías de la encuesta NEI-RQL-42 son los siguientes: "Claridad de visión": 93,75, "Expectativas": 75, "Visión cercana": 92,81, "Visión lejana": 94,83, "Fluctuaciones diurnas": 81,87, "Limitación de actividades": 95,1, "Glare/deslumbramiento": 68,75, "Síntomas": 73,56, "Dependencia de la corrección": 99,58, "Preocupación": 45, "Corrección subóptima": 100, "Apariencia": 92 y "Satisfacción con la corrección": 93. Conclusión: los 20 pacientes obtuvieron un buen puntaje en la mayoría de las categorías de la encuesta. Tener en cuenta los criterios descritos por el doctor Maeda podrían mejorar los resultados de la cirugía de catarata y facilitar la decisión del tipo de lente a implantar en cada paciente.

Background: it is reported that despite obtaining good visual results with multifocal lenses, some patients are not comfortable with their vision; There are few articles that objectively describe the satisfaction of patients after the implantation of this type of lens. Objective: To describe the results of the NEI-RQL-42 survey in patients who underwent cataract surgery with phacoemulsification and implant of a trifocal lens (FineVision) in both eyes. Study Design: Descriptive, cross-sectional study. Method: We included patients who underwent cataract surgery and a trifocal lens implant in both eyes (FineVision). All patients were evaluated with Pentacam before the surgery to ensure compliance with the criteria described by Dr. Maeda. Subsequently, the NEI-RQL-42 survey was completed and a comparison of means and proportions was made using the SPSS program version 19. Results: The average score for each category of the NEI-RQL-42 survey were the following: "Clarity of vision": 93.75, "Expectations": 75, "Near vision": 92.81, "Far vision": 94.83, "Diurnal fl uctuations": 81.87, "Activity limitations": 95.1, "Glare": 68.75, "Symptoms": 73.56, "Dependence on correction": 99.58, "Worry": 45, "Suboptimal correction": 100, "Appearance": 92 and "Satisfaction with correction": 93. Conclusion: The 20 patients interviewed obtained good results in most of the categories of the NEI-RQL-42 survey. Following the criteria described by Dr. Maeda could improve the results of cataract surgery and could facilitate the decision about the type of lens to implant in each patient.

Qualidade de vida e visão pós-facectomia / Quality of life and vision post-facectomy

Resumo Objetivo: A catarata é a principal causa de cegueira reversível no mundo e seu tratamento é baseado em cirurgia, facectomia. A evolução do procedimento tem se baseado em vários pilares, mas é no desenvolvimento de novos tipos de lentes intraoculares que vem mostrando inovações consideráveis. As lentes atuais são capazes, além de tratar a catarata, de corrigir erros refracionais. O objetivo deste estudo foi avaliar a qualidade de vida e de visão pós-facectomia, comparando as lentes multifocais (Restor), tóricas, monofocais esféricas (SN60AT) e monofocais asféricas. Métodos: A pesquisa abrangeu 54 pacientes submetidos a facectomia com implantação de uma das lentes há, pelo menos, 3 meses. Os pacientes responderam questionário de qualidade de vida Cataract TyPE Specification sobre satisfação de visão, dependência de óculos para diversas atividades diárias e presença de fenômenos disfóticos. Para análise dos dados foram utilizados os testes de Kolmogorov-Smirnov, quanto a normalidade e ANOVA com teste de Tukey, quanta parametria. Em comparações não paramétricas, utilizou-se o teste de Mann-Whitney. Em todas as análises foi usado o mesmo nível de significância (p<0,05). Resultados: Numa escala de 0 a 10, a pesquisa mostrou que as lentes SN60AT, esféricas monofocais, foram as que obtiveram menor nível de satisfação entre as 4 lentes, obtendo média de 8,7 (DP= 1,30; IC ± 0,655), seguido das esféricas monofocais (média= 8,3 - DP= 1,83; IC ± 0,927), das esféricas multifocais (Restor) (média = 8,9 - DP = 1,42; IC ± 0,721) e as tóricas (média = 9,1 - DP = 1,67; IC ± 0,844) como a de maior nível de satisfação. Em relação à dependência dos óculos, a lente Restor foi a que mostrou melhor desempenho, com menor dependência dos óculos. Fenômenos disfóticos foram mais frequentes nos pacientes que tiveram implantada a lente SN60AT seguida de lente Restor. Conclusão: Conclui-se que as lentes SN60AT foram as lentes que causaram menor grau de satisfação, tendo os fenômenos disfóticos umas das principais queixas, associada a dependência dos óculos pós-cirurgia. Os pacientes que tiveram as lentes Restor implantadas, apesar dos sintomas disfóticos mais presentes do que as lentes monofocais tóricas e monofocais esféricas, tem o mesmo nível de satisfação, e ainda proporciona maior independência dos óculos.

Abstract Objective: Cataract is the leading cause of reversible blindness in the world and its treatment is based on surgery, facectomy. The evolution of the procedure has been based on several pillars, but it is in the development of new types of intraocular lenses that has been showing considerable innovations. Current lenses are capable, in addition to treating cataracts, of correcting refractive errors. The aim of this study was to evaluate the quality of life and post-facectomy vision, comparing multifocal lenses (Restor), toric, spherical monofocals (SN60AT) and aspheric monofocals. Methods: The study included 54 patients undergoing a facectomy with implantation of one of the lenses for at least 3 months. The patients answered questionnaire quality of life Cataract TyPE Specification on vision satisfaction, glasses dependence for various daily activities and presence of dysphothetic phenomena. For the analysis of the data, the Kolmogorov-Smirnov tests were used, regarding normality and ANOVA with Tukey's test, how much parametric. In non-parametric comparisons, the Mann-Whitney test was used. In all analyzes, the same level of significance was used (p <0.05). Results: On a scale of 0 to 10, the research showed that single-spherical spherical SN60AT lenses were the ones that obtained the lowest level of satisfaction among the four lenses, obtaining an average of 8.7 (SD = 1.30, CI ± 0.655), followed (mean = 8.9 - SD = 1.42, CI ± 0.721) and the toric (mean = 8.3 - SD = 1.83, CI ± 0.927), multifocal spherical (Restor) 9.1 - SD = 1.67, CI ± 0.844) as the highest level of satisfaction. Regarding the dependence of the glasses, the Restor lens showed the best performance, with less dependence on the glasses. Dysphasic phenomena were more frequent in patients who had implanted the SN60AT lens followed by Restor lens. Conclusion: It is concluded that the SN60AT lenses were the lenses that caused less satisfaction, and the dysphothetic phenomena were one of the main complaints, associated with the postoperative glasses dependence. Patients who had restored Restor lenses, despite the more present dysphoric symptoms than spherical monofocal and single-focal lenses, have the same level of satisfaction, and still provide greater independence of the glasses.

Resultados visuales de los lentes multifocales tóricos en la Fundación Oftalmológica de Santander / Visual results of toric multifocal intraocular lenses at Fundación Oftalmológica de Santander

Objetivo: evaluar los resultados visuales después de cirugía de catarata con implante de lente multifocal tórico. Materiales y Métodos: se realizó un estudio observacional descriptivo tipo serie de casos, de pacientes que se operaron de catarata con implante de lente multifocal tórico Acrysoft IQ Restor (Alcon Labs, Inc, Fort Worth Texas) desde Abril del 2011 hasta Abril de 2013 en la Fundación Oftalmológica de Santander (FOSCAL). Se evaluaron la agudeza visual sin corrección en visión lejana (AVSCVL, a 6 m) y cercana (AVSCVC a 40cm), el equivalente esférico postoperatorio (EEPOP), el astigmatismo refractivo residual, el astigmatismo inducido por el cirujano (AIC) y el uso de gafas a los 3 meses del post-operatorio. Resultados: el estudio incluyó 36 ojos (23 pacientes) con catarata y astigmatismo corneal. La AVSCVL promedio post-operatoria fue 0.21 logMAR, la AVSCVC promedio post-operatoria fue 0.22 logMAR. El EEPOP fué 0.1 D. El astigmatismo refractivo residual promedio fue -0.34 D. El astigmatismo inducido por el cirujano fue de 0.36 D. El uso de gafas para la visión lejana, próxima y en ambas distancias fue de 0%, 13% y 17% respectivamente. El 65% del total de los pacientes no usa gafas. Conclusión: el implante de lente multifocal tórico en pacientes con catarata y astigmatismo corneal regular muestra muy buenos resultados en la agudeza visual lejana y cercana, permitiendo a los pacientes gozar de independencia de gafas.

Objective: to evaluate visual outcomes after cataract surgery with toric multifocal intraocular lens (IOL). Materials and Methods: this is a case series study which included patients who had cataract surgery with implantation of an Acrysof IQ Restor toric IOL from April 2011 until April 2013 at Fundación Oftalmológica de Santander (FOSCAL). We evaluated uncorrected distance visual acuity, uncorrected near visual acuity, spherical equivalent refraction, residual astigmatism, surgeon induced astigmatism and spectacles use at 3 months post-operatively. Results: the study included 36 eyes (23 patients) with cataract and corneal astigmatism. The mean UCDVA was 0.21 logMAR, mean UCNVA was 0.22 logMAR. The spherical equivalent was 0.1 D. The residual refractive astigmatism was -0.34 D. Surgeon-induced astigmatism was 0.36 D. The use of glasses for distance vision, near vision and both was 0 %, 13 % and 17 %, respectively. 65% of the patients don't wear glasses. Conclusion: implantation of toric multifocal IOL in patients with cataract and regular corneal astigmatism showed good outcomes in distance and near vision, allowing patients get independence from spectacle wear.

Resultados visuales en pacientes operados de catarata con lente intraocular multifocal modelo OcuFlex / Visual results achieved in patients operated on from cataract with the use of OcuFlex multifocal intraocular lenses

OBJETIVO: Describir los resultados visuales en 8 pacientes operados de catarata bilateral con la técnica de Faco-chop e implante de lente intraocular multifocal modelo OcuFlex, en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer", desde septiembre del 2007 a febrero del 2008. MÉTODOS: Se realizó un estudio observacional, descriptivo, longitudinal y prospectivo donde se analizaron variables como: edad, sexo, agudeza visual sin corrección y la mejor agudeza visual corregida a diferentes distancias. Se utilizó la estadística descriptiva en el análisis de los datos con ayuda del sistema Microsoft Excel y Word 2003, para Windows XP. RESULTADOS: Se encontró que la edad media fue de 68,5 años. La agudeza visual media para lejos preoperatoria y posoperatoria, monocular y espontánea (sin corrección) fue de 0,17 y 0,8, respectivamente y la agudeza visual corregida fue de 0,41 y 0,98. En el posoperatorio se encontró que el 93,75 por ciento de los casos alcanzaban en visión monocular espontánea un J3 o mejor como agudeza visual Intermedia y un J1 de cerca. CONCLUSIONES: Los lentes multifocales disminuyen la dependencia de las gafas después de la cirugía de catarata, lo que constituye una buena opción en la recuperación de la función visual óptima.

OBJECTIVE: To describe the visual results of 8 patients operated on from bilateral cataract using Phaco-chop technique and implantation of OcuFlex multifocal intraocular lens at "Ramón Pando Ferrer" Cuban Institute of Ophthalmology from September 2007 to February 2008. METHODS: A prospective, longitudinal, observational and descriptive study was conducted to analyze variables such as age, sex, visual acuity without correction and best corrected acuity at different focal distances. Summary measures were used in analyzing data, with the support of Microsoft Excel and Word 2003 system for Windows XP. RESULTS: It was found that average age was 68.5 years. The average visual acuity for far distances before and after surgery, monocular and spontaneous (without correction) was 0.17 and 0.8 respectively whereas corrected visual acuity was 0.41 and 0.98 respectively. At the postoperative phase, the spontaneous monocular vision in 93.75 percent of patients reached J3 or better as intermediate visual acuity and J1 as near visual acuity. CONCLUSIONS: The multifocal lenses reduce the dependency on glasses after cataract surgery, which is a good choice for the recovery of optimal vision.