Authors: Eva Vyplasilova, MDKaterina Buusova Smeckova, MD, MBA

As. proff. Zdenek Smecka, MD, CSc.

Klinika ocni a esteticke chirurgie in ZlinCzech Republic

None of the authors has a financial interest on the presented data.

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Aim Methodsevaluation the satisfaction with

unilateral and bilateral UCVA in patients after implantation of AcrySof ReSTOR +3 IOL.

prediction of the final refraction (mainly Dcyl) and overall patient satisfaction.

determination the amount of dioptries when patients usually request a laser enhancement

findning recommendations about suitable procedures to be chosen.

Dissatisfaction with optical phenomenons like halo, glare, speed of focusing, eye dryness and surgery or speed of recovery were not taken into account.

Preoperative BCVA, autorefractometry values and corneal astigmatism values from the IOL Master were measured. Lens clearness and pathologies were evaluated.

Standard cataract / RLE surgery was performed-Infinity phaco, incision 2,2mm, one surgeon, in the case of the higher astigmatism incision in the K max, no relaxation incisions.

Postoperatively was evaluated mono- and binocular UCVA, autorefractometry values, requests for glasses prescription, patient subjective satisfaction and laser enhancement rate- how many were requested and performed. ASCRS Boston 2010 2

Setting / Venue

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Results: Refraction:0,33 Dsf +/- 0,48 [-1,5; +2,50] 0,50 Dcyl +/- 0,79 [-5; 0]SE: 0,7 +/- 0,56 [-2,5; +2,6]UCVA: 0,83 [0,2; 1,5]

Subjective satisfaction:satisfied: 390 eyes 77 %parctially satisfied: 95 eyes 19% of

eyesunsatisfied: 23 eyes 4%

In 77% of cases was the astigmatism decreased,unchanged or increased by no more than 0,1Dcyl.

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Results- prediction of astigmatismGroup 0-0,5 Dcyl Residual astigmatismPreoperative on the average: O,33 Dcyl

0,39 Dcyl [0; 1,25] Postperative on the average:

55% or unchangedx

45% (max. by 0,75Dcyl)

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Results- prediction of astigmatismGroup 0,5- 1,0 Dcyl Residual astigmatismPreoperative on the average: O,74 Dcyl

0,54 Dcyl [0; 1,75] Postperative on the average:

82% or unchangedx 18%

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Results- prediction of astigmatismGroup 1,0– 1,5 Dcyl Residual astigmatismPreoperative on the average: 1,20 Dcyl

0,71 Dcyl Postperative on the average:

92% or unchangedx 8%

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Results- prediction of astigmatismGroup 1,5 Dcyl and more Residual astigmatismPreoperative on the average: 2,50 Dcyl

1,9 Dcyl Postperative on the average:

86% or unchangedx

14%

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Comparison with other means of correcting astigmatism

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Conclusion80% of patients had post-operative astigmatism equal or better, so it

is quite predictable.We recommend to tailor the solution upon the pre-operative corneal

astigmatism. When pre-operative corneal astigmatism is higher than 1,0Dcyl,

enhancement is highly possible. When more than 1,5Dcyl is measured, enhancement or other

correction means (toric IOL) should be planned.Toric multifocal IOLs are technically very complex and according to

our experience there might be a problem with their prediction and sometimes the dispersion in sphere or cylinder may be as high as 1,5D,

When the result with toric MIOL is not perfect, enhancement is necessary and this modality increases costs for the clinic and patients are often distempered.

That's why we prefer the alternative of MIOL followed by laser enhancement. The main disadvantage are 2 surgeries, but the result is precise.

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