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      Comparison between OPD-Scan results and visual outcomes of monofocal and multifocal intraocular lenses Translated title: Comparação dos resultados do OPD-Scan e performance visual das lentes intraoculares monofocal e multifocal

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          Abstract

          PURPOSE: To compare the visual outcome, contrast sensitivity and wavefront analysis of patients that underwent cataract surgery and implantation of AcrySof SN60D3 multifocal intraocular lens with those who received the AcrySof SN60AT monofocal IOL. METHODS: This was a prospective clinical trial of forty eyes that received the multifocal IOL and thirty-two eyes that received the monofocal IOL after phacoemulsification. RESULTS: Values for total and spherical aberrations in the multifocal group were statistically lower than in the monofocal group. In the monofocal group, 75% achieved uncorrected intermediate visual acuities between Jaeger 1 and 6. In the multifocal group, 75% of the eyes achieved more than Jaeger 6. At least 87.5% of the multifocal group and 6.3% of the monofocal group achieved monocular uncorrected near acuity of 20/30 (J2, N5) or better. And 90.0% of the eyes in the multifocal group and 37.5% in the monofocal group achieved an uncorrected near acuity of 20/40 (J3, N6) or better. The mean spherical error was 0.11 D in the multifocal group and -0.18 D in the monofocal group (p=0.0379). The SN60D3 group compared to SN60AT group had low contrast sensitivity (log units) with statistically significant differences in 6.0 cpd in photopic conditions (p=0.014) and the SN60D3 group compared to SN60AT group had higher contrast sensitivity (log units) under mesopic conditions (p=0.044). CONCLUSION: The multifocal IOLs induced less spherical aberration than monofocal IOLs and predictably good uncorrected distance and uncorrected near acuities. However, contrast sensitivity was lower in the multifocal group.

          Translated abstract

          OBJETIVO: Comparar a performance visual, sensibilidade ao contraste e de wavefront com OPD-Scan em pacientes submetidos a cirurgia de facoemulsificação com implante de lente intraocular AcrySof SN60D3 multifocal e AcrySof SA60AT monofocal. MÉTODOS: Quarenta olhos com a lente intraocular multifocal e trinta e dois olhos com a lente intraocular monofocal. A avaliação oftalmológica contou com medida da acuidade visual para longe, intermediária e curta distância, sem correção e com a melhor correção óptica, teste de sensibilidade ao contraste e análise de frente de onda por meio do aberrômetro OPD-Scan. RESULTADOS: As aberração total e aberração esférica no grupo multifocal foi estatisticamente inferior comparada com o grupo monofocal. No grupo monofocal 75% apresentaram acuidade visual monocular intermediária sem correção entre Jaeger 1 e 6, no grupo multifocal 75% apresentaram mais que Jaeger 6. Aproximadamente 87,5% do grupo multifocal e 6,3% do grupo monofocal apresentaram acuidade visual monocular sem correção para perto de 20/30 (J2, N5), ou melhor, e 90,0% dos olhos do grupo multifocal e 37,5% do grupo monofocal apresentaram acuidade visual monocular sem correção para perto de 20/40 (J3, N6) ou melhor. A média de erro esférico foi de 0,11 D no grupo multifocal e -0,18 D no grupo monofocal (p=0,0379). O grupo monofocal apresentou superioridade estatística na sensibilidade ao contraste em condições fotópicas (p=0,014) e mesópicas (p=0,0044) a 6 cpg quando comparada ao grupo multifocal. CONCLUSÃO: A lente intraocular multifocal apresentou menos aberração esférica comparada à lente intraocular monofocal, da prevista multifocalidade sem correção para longe e perto. Entretanto, o grupo multifocal apresentou baixa sensibilidade ao contraste.

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          European multicenter study of the AcrySof ReSTOR apodized diffractive intraocular lens.

          To report the safety and effectiveness of the AcrySof ReSTOR apodized diffractive intraocular lens (IOL), model MA60D3, when implanted into the capsular bag. Multicenter European study including university clinics, eye hospitals, and private ophthalmic surgical centers. One hundred twenty-seven subjects implanted in cataractous eyes in an open multicenter study. After phacoemulsification, the foldable 3-piece hydrophobic acrylic apodized diffractive IOL was implanted in the capsular bag using a Monarch injector with an A-cartridge. The mean preoperative patient age was 68.4+/-12 years. Intraocular lens implant power ranged from 18.0 to 25.0 diopters (D) in 0.5-D increments. Distance visual acuity (VA), near VA, spectacle dependence, unwanted visual symptoms, and patient satisfaction. At the 6-month postoperative visit, binocular (both eyes simultaneously) mean uncorrected distance and near logarithm of the minimum angle of resolution VAs for the MA60D3 were 0.04+/-0.14 and 0.09+/-0.12 (n = 118), respectively. In addition, 88.0% and 84.6% of ReSTOR subjects achieved spectacle independence for distance and near vision, respectively. Glare and halos were reported as severe by only 8.5% and 4.2% of patients, respectively. Ninety-two percent of patients stated that they would choose to have the same lens implanted again after the first implant, and 95.7% answered likewise after the second implant. The AcrySof ReSTOR MA60D3 IOL demonstrated excellent near VA without compromising distance vision. Spectacle independence and patient satisfaction were high, whereas unwanted photic phenomena were clinically acceptable.
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            History and development of the apodized diffractive intraocular lens.

            The ReSTOR intraocular lens presents a unique apodized diffractive design within a refractive foldable acrylic optic, which makes an unprecedented level of mulifocal optical performance available. We describe the history and principles of diffractive optics used in the development of this refractive-diffractive IOL.
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              Visual performance of AcrySof ReSTOR apodized diffractive IOL: a prospective comparative trial.

              Evaluate the visual performance of the AcrySof ReSTOR intraocular lens (IOL) and compare it with the monofocal SA60AT IOL. Prospective, nonrandomized, clinical trial. Forty patients (80 eyes) from the Federal University of São Paulo were enrolled in two groups. Twenty-five patients were assigned to the ReSTOR group and 15 patients to the monofocal group. Inclusion criteria were corneal astigmatism 0.2 logMAR units, and no associated ocular diseases. Parameters analyzed included distance uncorrected and best-corrected visual acuity, near uncorrected and distance corrected visual acuity, intermediate visual acuity, contrast sensitivity (Pelli-Robson chart), stereopsis (Titmus test), reading speed, wavefront measurement (LADARWave aberrometer), and a quality-of-life questionnaire. main outcome measure: Distance and near uncorrected and best distance corrected visual acuity, contrast sensitivity, and reading speed. Distance uncorrected and best-corrected visual acuity in the ReSTOR group were not statistically different from the monofocal group (P = .66). Near uncorrected and distance corrected visual acuity were statistically better in the ReSTOR group than the monofocal group (0.16 +/- 0.13 vs 0.62 +/- 0.09, P < .001, and 0.14 +/- 0.12 vs 0.62 +/- 0.07, P < .001, respectively). The ReSTOR group demonstrated less spherical aberrations compared with the monofocal group (P < .001). Monocular photopic contrast sensitivity was statistically lower in the ReSTOR group (P < .001). Stereopsis and reading speed were not statistically different between the groups. The AcrySof ReSTOR IOL provides a satisfactory full range of vision and achieves a more satisfactory quality of life when compared with the monofocal SA60AT IOL, but with lower contrast sensitivity.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                abo
                Arquivos Brasileiros de Oftalmologia
                Arq. Bras. Oftalmol.
                Conselho Brasileiro de Oftalmologia (São Paulo, SP, Brazil )
                0004-2749
                1678-2925
                August 2009
                : 72
                : 4
                : 526-532
                Affiliations
                [06] São Paulo SP orgnameUSP Brazil
                [02] São Paulo SP orgnameSanta Casa de Misericórdia de São Paulo Brazil
                [07] São Paulo SP orgnameUSP Brazil
                [05] São Paulo SP orgnameUSP orgdiv1Faculdade de Medicina Brazil
                [04] São Paulo SP orgnameUSP orgdiv1Departamento de Oftalmologia
                [01] São Paulo SP orgnameUniversidade de São Paulo orgdiv1Faculdade de Medicina Brazil
                [03] São Paulo SP orgnameUSP Brazil
                Article
                S0004-27492009000400017
                10.1590/S0004-27492009000400017
                19820794
                94c5cea1-66e7-4c4c-b27a-545a35aea410

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 15 July 2007
                : 20 May 2009
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 30, Pages: 7
                Product

                SciELO Brazil


                Acuidade visual,Facoemulsificação,Catarata,Visual acuity,Cataract,Lens implantation, intraocular,Intraocular lenses,Phacoemulsification,Lentes intraoculares,Implante de lente intraocular

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