The impact of astigmatism on visual acuity and quality of vision in eyes implanted with presbyopia-correcting IOLs

Session Details

Session Title: Cataract
Session Date/Time: Saturday 11/02/2017 | 08:30-11:00
Paper Time: 09:48
Venue: Auditorium 1

First Author: F.Carones ITALY
Co Author(s): L. Vigo                 

Abstract Details

Purpose:

Clinical daily practice shows that patients undergoing presbyopia-correcting IOLs implant need to reach refractive outcomes as close as possible to plano for best performances in terms of uncorrected visual acuity and quality of vision. The purpose of this study was to evaluate the impact of induced astigmatism on eyes already implanted with diffractive bifocal, trifocal and extended depth of focus IOLs.

Setting:

Carones Ophthalmology Center, Milan Italy

Methods:

A retrospective interventional case series was conducted with 80 patients (80 eyes) who were implanted with either a ReSTOR 2.5 (Alcon Laboratories, 20 eyes), a ReSTOR 3.0 (Alcon laboratories, 20 eyes), a PanOptix (Alcon Laboratories, 20 eyes) or a Symfony IOL (AMO, 20 eyes). After manifest refraction and best spectacle-corrected visual acuity measurement, the eyes were assessed at the phoropter to measure the impact on visual acuity (decimal fraction) and patient satisfaction (scale 1-4) of increasing levels of astigmatism (0.25 D to 1.50 D, plus and minus sign, 90ﾰand 180ﾰ).

Results:

There was no significant difference between IOLs with regard to the impact of the cylinder sign and axis. When the added cylinder was equal or less than 0.50 D, ReSTOR +2.5 and Symfony maintained the baseline visual acuity (1.2), while it was mildly reduced with the ReSTOR 3.0 and PanOptix from 1.2 to 1.0. If the induced cylinder was 1 D, the Symfony still achieved good visual acuity (0.8) with a high level of satisfaction associated. PanOptix was the IOL most affected by the induced astigmatism, showing the highest level of dissatisfaction and a significant lowering of visual acuity (0.6).

Conclusions:

For all tested IOLs, there was a threshold value at 0.75 D induced astigmatism where visual acuity decreased and satisfaction levels dropped. The four IOLs performed differently, being Symfony the less sensitive and PanOptix the most sensitive ones to induced astigmatism. As a consequence of these results, we believe that estimated residual cylinder should be 0.50 D or less for best performances and highest patient satisfaction, when planning for surgery for the implant of presbyopia-correcting IOLs.

Financial Disclosure:

receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented, travel has been funded, fully or partially, by a competing company, travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented, research is funded, fully or partially, by a company producing, developing or supplying the product or procedure presented, receives nonNonemonetary benefits from a competing company., receives consulting fees, retainer, or contract payments from a competing company