Surgically-induced astigmatism in clear lens extraction and implantation of a multifocal lens: a refractive and vector analysis

Session Details

Session Title: Moderated Poster Session: Trends in Refractive Surgery

Venue: Poster Village: Pod 1

First Author: : E.Bigdon GERMANY

Co Author(s): :    N. Steinhorst                       

Abstract Details

Purpose:

To analyze the surgically induced ocular residual Astigmatism (siORA) anterior topographic and refractive changes (tSIA, rSIA)) after clear lens extraction and implantation of sphere multifocal intraocular lens (mIOL).

Setting:

University Hospital, Hamburg, Germany

Methods:

This study comprised patients with clear lens extraction that had surgery with diffractive non-toric mIOL implantation with planned LASIK touch-up. Changes in rSIA, tSIA and siORA before touch-up were evaluated over 1-3 months.

Results:

The study enrolled 106 eyes (56 patients). The mean preoperative refractive astigmatism was changed from 1.31D±1.12D(-5.25D to 0.00D) to -1.17D±0.83D (-4.00D to 0.00D) postoperatively. Preoperative topographic astigmatism was changed from 1.24D±1.01 (-5.25D to 0.00D) to -1.21D±0.85D (-4.10D to -0.10D) postoperative. The refractive astigmatism magnitude decreased more than the anterior topographical astigmatism magnitude. Both tSIA and siORA contribute to the rSIA. The vector analysis showed that tSIA affected rSIA less than siORA (p =0.00003). The induced ORA increased significantly with siORA of 0.87D±0.58D (0.04D und 4.23D).

Conclusions:

The tSIA caused decreased astigmatism. The unpredictable rSIA is rather caused through siORA than tSIA. The postoperative ORA is not predictable and may be dependent on additional factors (effective lens position and tilt, change of the posterior corneal curvature, macular changes). Our results may indicate that a non predictable SIA can not be corrected with a selection of torical mIOL. It should be readjusted with the Excimer Laser instead.

Financial Disclosure:

None