Facochop en la facopremium

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Abstract

La cirugía de catarata se ha convertido en Oftalmología en uno de los procedimientos quirúrgicos de excelencia tanto en su planificación, como en sus resultados. En la facoemulsificación premium hay que tener una estrecha comunicación con el paciente, para conocer sus necesidades visuales y planificar adecuadamente la cirugía. Se analizan los aspectos fundamentales del proceder desde el examen oftalmológico inicial, los cálculos biométricos, la lente intraocular más apropiada, así como las máquinas de facoemulsificación que se utilizarán en la cirugía para permitir resultados óptimos y controlados.

Translated abstract

The cataract surgery has become one of the surgical procedures of excellence in ophthalmology in terms of planning and results. In the phacoemulsificación premium, one must have close communication with the patient find out his visual needs and to adequately plan the surgery. The fundamental aspects of the procedure including the initial ophthalmologic exam, the biometric calculations, the selection of the most suitable intraocular lens, as well as the phacoemulsification equipment to be used in surgery are all analyzed in order to achieve optimal controlled results.

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Most cited references 25

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One-year outcomes with new-generation multifocal intraocular lenses.

Alessandra Casuccio, Francesco Pillitteri, Raffaella Morreale Bubella … (2008)

To compare new-generation multifocal intraocular lenses (IOLs) with monofocal IOLs. Randomized prospective clinical trial. Sixty-two consecutive patients with cataract, seen between January of 2005 and January of 2006 at the Department of Ophthalmology of Palermo University Hospital in Italy, were bilaterally implanted with monofocal (AR 40, Advanced Medical Optics [AMO], Santa Ana, CA; 15 patients), multifocal refractive (Array SA40N, AMO; 16 patients), multifocal refractive (ReZoom, AMO; 15 patients), or multifocal diffractive pupil-independent (Tecnis ZM900, AMO; 16 patients) IOLs. Bimanual phacoemulsification. Primary outcomes were far, near, and intermediate visual acuity of the 4 IOL-implanted groups. Secondary outcomes were defocusing curves, contrast sensitivity, patients' quality of life (7-item visual function questionnaire [VF-7], halos and glare presence, overall satisfaction), and spectacle independence. Snellen visual acuity was measured as uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), uncorrected near visual acuity (UCNVA), best distance corrected near visual acuity (BDCNVA), best corrected near visual acuity (BCNVA), uncorrected intermediate visual acuity (UCIVA), and best distance corrected intermediate visual acuity (BDCIVA). UCNVA was 20/50 in the monofocal IOL group, compared with 20/32 or better in the multifocal IOL groups (P<0.0005). The monofocal IOL group exhibited a lower BDCNVA than the multifocal IOL groups (P<0.0005). The diffractive multifocal IOL group performed better than either refractive group (P = 0.007). UCIVA was significantly different (P = 0.001) among the groups: monofocal (AR 40) 20/32; multifocal refractive (Array SA40N) 20/30; multifocal refractive (ReZoom) 20/25; and multifocal diffractive (Tecnis ZM900) 20/30. Defocusing curves with -3.00 diopter lens exhibited a better trend in the diffractive group. The refractive multifocal IOL groups exhibited lower contrast sensitivities at 3 cycles/degree (P = 0.038). The VF-7 mean score was significantly lower in the monofocal than the multifocal IOL groups (P = 0.002). Night halos were more common in the refractive groups (P<0.01). Spectacle independence was 20% in the monofocal IOL group, 43.7% and 53.3% in the refractive multifocal IOL groups, and 87.5% in the diffractive multifocal IOL group (P<0.05). Multifocal IOLs provide a greater depth of focus and higher patient satisfaction, and make intermediate and near visual tasks easier than do monofocal lenses. New-generation, diffractive, pupil-independent multifocal IOLs provide better near vision, equivalent intermediate vision, less unwanted photic phenomena, and greater spectacle independence than either monofocal or refractive multifocal IOLs.

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Visual performance of patients with bilateral vs combination Crystalens, ReZoom, and ReSTOR intraocular lens implants.

Jay S. Pepose, Mujtaba Qazi, James Davies … (2007)

To compare the visual performance of patients with bilateral vs combination Crystalens, ReZoom, and ReSTOR intraocular lens (IOLs) implants. Prospective, nonrandomized study. Forty-nine patients were implanted with bilateral Crystalens (Eyeonics, Aliso Viejo, California, USA), ReSTOR (Alcon Laboratories, Fort Worth, Texas, USA), and ReZoom (American Medical Optics, Santa Clara, California, USA) or combined Crystalens and ReSTOR or Crystalens and ReZoom IOLs after phacoemulsification. Monocular and binocular testing four to six months after surgery included uncorrected and best-spectacle corrected visual acuity at distance, intermediate, and near vision; mesopic contrast sensitivity function with and without glare; and quality-of-life and vision surveys six months after surgery. Monocular testing showed that eyes with Crystalens accommodating IOL had statistically better best-spectacle corrected distance, uncorrected and distance-corrected intermediate, and best-corrected near vision. Eyes with the ReSTOR multifocal IOL had better uncorrected near vision, required the lowest reading add, and had the lowest uncorrected and distance-corrected intermediate vision. Monocular mesopic contrast sensitivity with and without glare was better with the Crystalens IOL vs either multifocal IOL at specific spatial frequencies. The binocular subjective quality of vision and quality of life questionnaires were favorable for the bilateral Crystalens group. Any combination of Crystalens in one or both eyes was better for intermediate vision. Any combination of ReSTOR in one or both eyes was better for near vision. The Crystalens and ReSTOR combination had better mean intermediate and near vision overall. A multifocal IOL in one or both eyes was associated with lower contrast sensitivity and more subjective reports of photic phenomena. The accommodating and multifocal IOL combinations elicited less night glare symptoms than in patients with either bilateral multifocal IOL, but more than with bilateral Crystalens implantation.

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Refractive lens exchange with foldable toric intraocular lens.

Ramón Ruiz-Mesa, Daniel Carrasco-Sánchez, Sara B. Díaz-Álvarez … (2009)

To assess visual and refractive outcomes, and rotational stability after refractive lens exchange (RLE) with toric intraocular lens (IOL) implantation to correct ametropia and preexisting astigmatism. Prospective, nonrandomized, observational case series (self-controlled). This prospective, nonrandomized, and self-controlled study included 32 eyes of 19 consecutive patients with more than 1.00 diopter (D) of preexisting corneal astigmatism having RLE with AcrySof Toric IOL implantation (Alcon Laboratories Inc, Fort Worth, Texas, USA). Uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), refractive sphere, and keratometric and refractive cylinder were recorded preoperatively and 6 months after surgery. Toric IOL axis shift was also measured. A patient satisfaction, visual phenomena, and spectacle dependency questionnaire was also carried out. At 6 months postoperatively, UCVA was 20/32 or better in 100% of the eyes, with 84.3% achieving 20/25 or better. One hundred percent of eyes achieved 20/25 or better BCVA. No eye lost >or=2 lines, 1 eye lost 1 line, 16 eyes did not change, 4 eyes gained 1 line, and 11 eyes gained >or=2 lines of BCVA after the surgery. Mean refractive cylinder was reduced significantly after surgery from -2.46 +/- 0.99 D to -0.53 +/- 0.30 D (P < .001). Vector analysis to compare attempted vs achieved correction showed that 100% of eyes were within +/- 1.00 D for the spherical equivalent, and 100% of eyes were within +/-0.50 D for the astigmatic components (J(0) and J(45)). Mean toric IOL axis rotation was 0.90 +/- 1.76 degrees, being

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Author and article information

Contributors

Juan Raúl Hernández Silva: Role: ND

Marcelino Rio Torres: Role: ND

Meisy Ramos López: Role: ND

Luis Curbelo Cunill: Role: ND

Yanay Ramos Pereira: Role: ND

Imalvet Santiesteban Garcia: Role: ND

Anneé Miranda Carracedo: Role: ND

Marietta Gutiérrez Castillo: Role: ND

Heidy Hernández Ramos: Role: ND

Journal

Journal ID (publisher): oft

Title: Revista Cubana de Oftalmología

Abbreviated Title: Rev Cubana Oftalmol

Publisher: Editorial Ciencias Médicas (Ciudad de la Habana )

ISSN: 1561-3070

Publication date (Print): June 2014

Volume: 27

Issue: 2

Pages: 246-252

Affiliations

[1 ] Instituto Cubano de Oftalmología Ramón Pando Ferrer Cuba

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Publisher ID: S0864-21762014000200009

SO-VID: aecfe426-e1ac-4647-bc9f-a7ffe6eaa805

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http://creativecommons.org/licenses/by/4.0/

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SciELO Cuba

Self URI (journal page): http://scielo.sld.cu/scielo.php?script=sci_serial&pid=0864-2176&lng=en

Facochop en la facopremium Translated title: Facochop in facopremium

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Abstract

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SciELO Cuba

Most cited references 25

One-year outcomes with new-generation multifocal intraocular lenses.

Visual performance of patients with bilateral vs combination Crystalens, ReZoom, and ReSTOR intraocular lens implants.

Refractive lens exchange with foldable toric intraocular lens.

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