RESUMO
BACKGROUND: This study aimed to compare the clinical outcomes of implantation of various multifocal intraocular lenses (mIOLs) and the prediction accuracy of two intraocular lens (IOL) power calculation formulas for eyes that underwent previous corneal refractive surgery. METHODS: Four types of mIOLs [TECNIS Symfony (Group I), AcrySof IQ PanOptix (Group II), LENTIS Mplus (Group III), and TECNIS ZLB00 (Group IV)] were used and the IOL power was calculated with the two no-history methods, Shammas-PL and Barrett True-K. Visual acuity and refractive outcomes including manifest refraction, prediction error (PE), absolute error (AE), and median absolute error (MedAE) were evaluated at three months after the cataract surgery. RESULTS: For all groups the Barrett True-K formula produced a narrower range of PEs and lower MedAE than Shammas-PL. Eyes of lower predictive accuracy (group B, AE >0.5D) showed weak uncorrected distance visual acuity resulting from myopic refractive error and target refraction when compared to that of higher predictive accuracy (group A, AE ≤0.5 D). CONCLUSIONS: Targeting emmetropia using the Barrett True-K, which considers both anterior and posterior corneal curvature is recommended in patients undergoing mIOL implantation with prior corneal refractive surgery. Additionally, history of prior large amount of laser ablation seems to be an important factor related to low predictive accuracy.
RESUMO
PURPOSE: To compare clinical outcomes of a 1.8 mm and a 2.2 mm microcoaxial cataract surgery system. SETTING: Department of Ophthalmology and Visual Science, Kangnam St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea. METHODS: In a prospective study, eyes were randomly selected to have phacoemulsification using a Stellaris system or an Intrepid Infiniti system. The initial incision size was 1.8 mm and 2.2 mm, respectively. Measured intraoperative parameters included phacoemulsification time, mean cumulative dissipated ultrasound energy (CDE), change in incision size at each step of surgery, and total volume of balanced salt solution (BSS) used. The best corrected visual acuity (BCVA), corneal astigmatism, corneal thickness, and endothelial cell count were evaluated preoperatively and postoperatively. RESULTS: The study evaluated 86 eyes of 78 patients (43 eyes in each group). There were no significant differences in postoperative BCVA, surgically induced astigmatism, or amount of BSS used between the 2 systems (P >.05). However, for high-density cataracts, the 1.8 mm group had a greater change between the initial incision size and the incision size after phacoemulsification (P = .019, nuclear opalescence [NO] NO3; P = .001, NO4), a longer phacoemulsification time (P = .013, NO3), greater mean CDE (P = .005, NO3; P = .001, NO4), and greater corneal endothelial cell loss (P = .003, NO4). CONCLUSIONS: Both systems were safe and effective in microcoaxial phacoemulsification. The 1.8 mm system performed better with cortical-type cataract and the 2.2 mm system, with high-density nuclear-type cataract.
