Effect of Spherical Equivalent Error on Visual Acuity at Various Distances in Eyes With a Trifocal Intraocular Lens.

PURPOSE: To examine the effect of manifest refraction spherical equivalent error on visual acuity at various distances in eyes that received a trifocal intraocular lens (IOL). METHODS: Sixty eyes of 30 patients who underwent bilateral implantation of a trifocal IOL (Alcon PanOptix TFNT00; Alcon Laboratories, Inc., Fort Worth, TX) were enrolled. Corrected visual acuity from far to near distances was measured using an all-distance vision tester after simulating the spherical equivalent error by adding spherical lenses with refractive powers of +1.00, +0.50, 0.00, -0.50, and -1.00 diopters (D); addition of a plus lens simulates myopia, whereas addition of a minus lens simulates hyperopia. RESULTS: Mean visual acuity at all distances differed significantly among the spherical lens added groups (P ≤ .0374). Mean distance visual acuity at infinity, 5, and 3 m was significantly worse in all lens added groups (+1.00, +0.50, -0.50, and -1.00 D) than in the no lens group (P < .0001). Mean intermediate visual acuity at 1 and 0.7 m did not differ significantly between each of the lens added groups and the no lens group. Mean near visual acuity at 0.3 m was significantly better in the +1.00 and +0.50 D groups and significantly worse in the -0.50 and -1.00 D groups than in the no lens group (P ≤ .0044). CONCLUSIONS: A manifest spherical equivalent error of slight myopia significantly improved near visual acuity but worsened distance visual acuity, whereas that of slight hyperopia worsened both distance and near visual acuity in eyes with trifocal IOLs, suggesting that slight myopia is a better target refraction than slight hyperopia, although emmetropia is the optimum target. [J Refract Surg. 2019;35(5):274-279.].

Effect of Topical Hypotensive Medications for Preventing Intraocular Pressure Increase after Cataract Surgery in Eyes with Glaucoma.

PURPOSE: To compare the effects of a topical intraocular pressure (IOP)-lowering medication for preventing an IOP increase after cataract surgery in eyes with glaucoma. DESIGN: Randomized clinical study. METHODS: A total of 165 eyes of 165 patients with primary open-angle glaucoma or pseudoexfoliation glaucoma scheduled for phacoemulsification were randomly assigned to 1 of 3 groups to receive each medication immediately postoperatively: 1) prostaglandin F2α analog (travoprost), 2) ß-blocker (timolol maleate), or 3) carbonic anhydrase inhibitor (brinzolamide). Intraocular pressure (IOP) was measured using a rebound tonometer at 1 hour preoperatively, at the end of surgery, and at 2, 4, 6, 8, and 24 hours postoperatively. The incidence of eyes exhibiting a marked IOP increase to greater than 25 mm Hg was compared among the groups. RESULTS: At 1 hour preoperatively and at the end of surgery, mean IOP did not differ significantly among the groups. Mean IOP increased significantly between 4 and 8 hours postoperatively and then decreased at 24 hours postoperatively in all groups (P < .0001). Mean IOP was significantly lower in the brinzolamide group than in the travoprost or timolol group at 4, 6, and 8 hours postoperatively (P ≤ .0374) and did not differ significantly among groups at 2 and 24 hours postoperatively. The incidence of an IOP spike was significantly lower in the brinzolamide group than in the travoprost and timolol groups (P = .0029). CONCLUSIONS: Brinzolamide reduces the short-term IOP increase after cataract surgery more effectively than travoprost or timolol in eyes with glaucoma, suggesting that brinzolamide is preferable for preventing an IOP spike.