ABSTRACT
PURPOSE: To compare postcataract surgery visual and optical performance between two trifocal intraocular lenses (IOLs) with the same optical design: a hydrophobic acrylic glistening-free IOL and a hydrophilic acrylic IOL. METHODS: Patients were bilaterally implanted with either the hydrophobic or the hydrophilic IOL. The data of the patients' right eyes were evaluated. Visual quality assessments included refractive outcomes, monocular visual acuity (VA) at far, intermediate, and near distances, defocus curve, aberrations (spherical aberration (SA)), root mean square (RMS) of corneal, internal, and total higher-order aberrations (HOAs)), and tilt of IOL. RESULTS: Fifty-one patients were included in the analysis: 26 patients implanted with the hydrophobic IOL and 25 patients implanted with the hydrophilic IOL. At 1 month, no statistically significant differences were found for monocular uncorrected and corrected VA at distance, distance-corrected VA at intermediate and near, defocus curve, manifest spherical equivalent, total SA, and RMS of the total, internal, and corneal HOA. The defocus curve of both groups showed a visual acuity of 0.3 logMAR or better in the intermediate range from 0.5 to -2.5 D of vergence level with no significant differences between the groups. Compared to the hydrophilic group, y-direction tilt was significantly higher in the hydrophobic group (p=0.027). The total tilt and x-axis tilt did not differ between the groups. CONCLUSION: Both IOLs demonstrated an excellent quality of vision and provided the patient with a wide range of vision.
ABSTRACT
PURPOSE: To demonstrate the influence of the surgeon's and the operating room (OR) technicians' experience upon the outcome of femtosecond laser-assisted cataract surgery (FLACS). MATERIALS AND METHODS: Our study included 250 eyes from 156 patients who had undergone either cataract surgery or clear-crystalline-lens extraction and where capsulorhexis and lens fragmentation had been performed using the CATALYS® Precision System femtosecond platform (Abbott Medical Optics Inc., Santa Ana, CA, USA).The patients were operated either by an experienced surgeon in the use of femtosecond laser or by an inexperienced surgeon in that field and two technicians. The quantitative outcome measures were: Suction loss rate, vacuum time, number of consumables used by the patient and intraoperative complication rate. RESULTS: Both for the experienced and the inexperienced surgeons, suction loss rates as well as vacuum time decreased progressively as time went by and more surgical procedures had been completed by that surgeon. For a given surgeon suction time decreased significantly, going from 137 to 99s, as the assisting technician gradually gained experience. The number of consumables used in each procedure by the experienced surgeon ranged from 1.10 (for the first 50 cases) to 1.02 from those initial cases onwards. Regarding intraoperative complications, they also decreased progressively as the number of procedures completed by the surgeon increased. CONCLUSIONS: The experience of each team member involved in such procedures-be it surgeons or technicians-have an impact, to a greater or lesser extent, upon the surgery's outcome, as quantified by the outcome variables of choice
OBJETIVO: Demostrar la influencia de la experiencia del cirujano y los técnicos de quirófano en los resultados de la cirugía de cataratas asistida por láser de femtosegundo (FLACS). MATERIALES Y MÉTODOS: Nuestro estudio incluyó 250 ojos de 156 pacientes sometidos a cirugía de cataratas o extracción de cristalino transparente, en las que la capsulorrexis y la fragmentación de lente se habían realizado utilizando la plataforma de femtosegundo CATALYS(R) Precision System (Abbott Medical Optics Inc., Santa Ana, CA, EEUU). Los pacientes fueron operados, bien por un cirujano con experiencia en el uso del láser de femtosegundo, o bien por un cirujano sin experiencia en dicho campo, y dos técnicos. Las medidas del resultado cuantitativo fueron: tasa de pérdida de succión, tiempo de vacío, número de consumibles utilizados por el paciente, y tasa de complicación intraoperatoria. RESULTADOS: Tanto para cirujanos expertos como inexpertos, las tasas de pérdida de succión, así como el tiempo de vacío disminuyeron progresivamente a medida que transcurría el tiempo, y que se incrementaba el número de intervenciones quirúrgicas completadas por el cirujano. Para un cirujano dado, el tiempo de succión disminuyó significativamente, pasando de 137 a 99 segundos, a medida que el técnico asistente ganaba experiencia gradualmente. El número de consumibles utilizados en cada procedimiento por un cirujano experto oscilaba entre 1,10 (para los primeros 50 casos) y 1,02 desde los casos iniciales en adelante. En cuanto a complicaciones intraoperatorias, también disminuyeron progresivamente a medida que aumentaba el número de intervenciones completadas por el cirujano. CONCLUSIONES: La experiencia de cada miembro del equipo involucrado en dichos procedimientos-bien fueran cirujanos o técnicos-tiene un impacto, en mayor o menor medida, sobre el resultado de la cirugía, según lo cuantificado por las variables de elección del resultado
Subject(s)
Humans , Cataract Extraction/education , Clinical Competence , Learning Curve , Surgeons/education , Health Personnel/education , Laser Therapy , Prospective Studies , Ophthalmologists/education , Cataract Extraction/methodsABSTRACT
PURPOSE: To compare clinical outcomes in a prospective trial of cataract surgery patients bilaterally implanted with two different trifocal intraocular lenses (IOLs) with very similar optical designs but consisting of different IOL materials (hydrophobic and hydrophilic). PATIENTS AND METHODS: Fifty-one patients (102 eyes) were randomized to receive trifocal IOLs bilaterally - FineVision POD F (hydrophilic) or FineVision POD F GF (hydrophobic) (both PhysIOL, Liége, Belgium). The follow-up period was 3 months. Outcome measurements included uncorrected distance (UDVA), corrected distance (CDVA), distance-corrected intermediate (DCIVA), and distance-corrected near visual acuity (DCNVA), refraction, negative dysphotopsia, optical quality of vision, contrast sensitivity under photopic and mesopic conditions, halometry (discrimination index), and patient-reported outcomes. RESULTS: At the final study visit, mean (SD) values for binocular UDVA, CDVA, DCIVA (80 cm), and DCNVA (40 cm) were -0.01 (0.06), -0.04 (0.04), 0.09 (0.10), and 0.10 (0.09) logMAR, respectively, for POD F, and 0.01 (0.08), -0.03 (0.03), 0.08 (0.1), and 0.13 (0.11) respectively, for POD F GF. Defocus assessments showed a continuous curve with a functional range of visual acuity (≤0.15 logMAR) from ~30 cm to infinity in both groups. The discrimination index was >0.85 for all patients, and both groups showed similar contrast sensitivity under photopic and mesopic conditions. At 3 months, no patient reported negative dysphotopsia, and high satisfaction rates were observed. CONCLUSION: Clinical outcomes showed no significant difference between each lens when measured at 1 month and 3 months after implantation. This equally good clinical performance of hydrophilic and hydrophobic trifocal lenses allows the surgeon to choose the IOL material based on personal preferences or patients' needs.
ABSTRACT
PURPOSE: To demonstrate the influence of the surgeon's and the operating room (OR) technicians' experience upon the outcome of femtosecond laser-assisted cataract surgery (FLACS). MATERIALS AND METHODS: Our study included 250 eyes from 156 patients who had undergone either cataract surgery or clear-crystalline-lens extraction and where capsulorhexis and lens fragmentation had been performed using the CATALYS® Precision System femtosecond platform (Abbott Medical Optics Inc., Santa Ana, CA, USA).The patients were operated either by an experienced surgeon in the use of femtosecond laser or by an inexperienced surgeon in that field and two technicians. The quantitative outcome measures were: Suction loss rate, vacuum time, number of consumables used by the patient and intraoperative complication rate. RESULTS: Both for the experienced and the inexperienced surgeons, suction loss rates as well as vacuum time decreased progressively as time went by and more surgical procedures had been completed by that surgeon. For a given surgeon suction time decreased significantly, going from 137 to 99s, as the assisting technician gradually gained experience. The number of consumables used in each procedure by the experienced surgeon ranged from 1.10 (for the first 50 cases) to 1.02 from those initial cases onwards. Regarding intraoperative complications, they also decreased progressively as the number of procedures completed by the surgeon increased. CONCLUSIONS: The experience of each team member involved in such procedures-be it surgeons or technicians-have an impact, to a greater or lesser extent, upon the surgery's outcome, as quantified by the outcome variables of choice.
