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Retrospective single centre study to analyse the refractive outcome objective, demographic profile and subjective patient satisfaction after bilateral aspheric plus 3 ReSTOR multifocal IOL implantation in 310 eyes of 155 patients over 5 years
Poster Details
First Author: N.Ray INDIA
Co Author(s):
Abstract Details
Purpose:
To assess the post operative refractive status ( 3 months) in uneventful phaco surgery with Restor Aspheric (Plus 3 )multifocal lens in a STAND ALONE private practice in Kolkata ,India ,without the support of BIOPTICS,Orbscan,IOL Master ,and contrast sensitivity measurement .The study also analyzed the demographic patient profile for those opting for this operation, and the predictability of relative spectacle freedom in the above scenario,the age and sex of patients opting for multifocals in a private clinic in Kolkata ,range of IOL Dioptric power and the gap between the 2 eye operations noted.
Setting:
All patients were operated by the author alone,with the Infinity machine,in a stand alone practice in Kolkata , India .Patients included did not have any ocular pathology,underwent bilateral Restor ,uncomplicated surgery ,single surgeon. On steep axis 2.2 mm clear corneal incision ,micro coaxial phaco with in the bag IOL placement .
Methods:
The patients were included in the study after the third month post operative check up.The unaided distance (Snellen/Log Mar ) vision,near vision reading speed ,dependence on extra illumination were noted. Question were asked relating to intermediate vision and contrast sensitivity.
All 310 patients were placed into 4 Groups according to Best uncorrected Visual Acuity in LogMar /Snellen equivalent,based on manifest refraction in SE( spherical equivalent 0-0.25D/0.25-0.5D/ 0.50-0.75D/0.75- 1D ) and into 4 groups each depending on post operative astigmatism on manifest refraction and pre existing K1/K2 readings difference .(0-0.25D/0.25-0.5D/ 0.50-0.75D/0.75- 1D ) and accuracy of Biometry by assessing the spherical error alone.
Distance ,reading and intermediate vision ,and reading speed(wpm) documented.
Results:
The demographic profile of 310patients in a private stand alone practice in Kolkata India showed 85 female and 70 male .The average age male was 61.4 years and female was 60.8 years consistent with the general cataractous age group.Myopic/hypermetropic distribution of Dioptric power of 310 Restor IOLs showed 109 eyes implanted with > 22.5 D and only 42 eyes implanted with < 19 D. Subjective satisfaction depending on unaided vision and independence from glasses studied.The average log Mar vision was calculated at 0.1 / 6/6p The predictability of SIA and on steep axis corneal incision to reduce pre operative astigmatism in Multifocal cases has been studied.Symptoms like haloes and glare were questioned.
Conclusions:
The ReStor lens yielded satisfactory results with careful patient selection even in a stand alone practice with minimum back up facilities in case of a major refractive surprise. Surgical precision and meticulous biometry and careful patient selection with exclusion of any ocular pathology and exclusion of hyper anxious personalities did play an important role.A strong will to be spectacle independent did play a very important role in the Multifocal acceptance levels in patients with a small residual refractive error. FINANCIAL INTEREST: NONE