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In this study, 20 patients underwent bilateral consecutive cataract surgery with multifocal mPlus IOL implantation. 10 patients were assigned to mPlus and 10 to mPlusX.
Defocus curve was elaborated two months after surgery to evaluate patient VA for different distances.

New mPlus X was found to enhance intermediate vision when compared to previous mPlus design.

Alvaro Rodríguez Ratón, MD1; Javier Orbegozo Gárate, MD1; Iñaki Basterra Barrenetxea,OD1

Purpose

To study the composition of corneal astigmatism in older adults, evaluating the difference made by the inclusion of posterior corneal astigmatism in a ray tracing calculation of total corneal astigmatism. SETTING: Ophthalmology clinic.

Methods

One hundred consecutive patients aged between 60 and 80 years were included in a prospective descriptive study. Their right eye was analysed by an integrated Placido disk and rotating Scheimpflug camera topographer (CSO Sirius). Several parameters were measured: anterior corneal astigmatism (ACA) and posterior corneal astigmatism (PCA), total astigmatism based on anterior topographic data (simK) and total corneal astigmatism (TCA) by merging anterior and posterior astigmatism using ray tracing.

Results

Mean ACA was 1.51 diopters (D) and PCA was 0.38D. ACA was aligned 47% with-the-rule and PCA 87% against-the-rule. Cases with against-the-rule ACA showed low magnitude correlation between anterior and posterior surfaces. TCA had a mean deviation of 0.30D @ 3 over SimK in a vector calculation. Eighteen percent (18%) of cases differed by 0.50 D or more between SimK and TCA magnitude, and 53% had 10 or more degrees of axis discrepancy, the difference being higher at lower magnitudes of astigmatism.

Conclussions

Anterior WTR astigmatism tends to be compensated by posterior ATR astigmatism in older patients. Nevertheless, the high number of cases largely justifies the use of tomographic technology that takes into account the posterior corneal surface for managing individual total corneal astigmatism.

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Objetivo

Evaluar la lente que produce una mejor calidad visual intermedia mediante una curva de defocus

Métodos

Estudio prospectivo descriptivo. Se implantan tres tipos de lente intraocular en pacientes adultos sin comorbilidad asociada: 20 lentes difractivas trifocales Zeiss Trilisa, 20 lentes difractivas bifocales AMO tecnis y 20 lentes refractivas Mplus. Se compara la visión simulada a diferentes distancias mediante curva de defocus.

Resultados

La lente trifocal Trilisa muestra una mejor AV en distancias intermedias respecto a las lentes comparadas AMO y Mplus.

Conclusiones

Actualmente las lentes trifocales aportan la mejor calidad visual en distancias intermedias, sin reducir significativamente el foco lejano y cercano.

Titulo

Vault tras implante de ICL basado en WtW y ACD

Objetivo

Analizar el espacio entre cara posterior de la ICL y la cara anterior del cristalino en pacientes implantados de esta lente desde 2010.

Métodos

Estudio retrospectivo descriptivo. Se analizan los resultados refractivos y vault de 46 ICL implantadas entre el año 2010 y 2013 en una clínica privada. Se recogen todas las incidencias quirúrgicas y en el seguimiento.

Resultados

El vault ha sido adecuado excepto en dos casos, cuya anatomía ciliar anómala queda demostrada por biomicroscopía ultrasónica (BMU). Solo se ha precisado un recambio por tamaño inadecuado y un explante de lente por hipertensión ocular incontrolable médicamente. Dos pacientes han presentado disfotopsias positivas.

Conclusiones

Los algoritmos clásicos basados en distancia blanco-blanco y amplitud de cámara anterior son aceptables para el implante de ICL. La BMU aportó información relevante sobre la anatomía del sulcus en 4,34% de los casos (2/46).

Purpose

Analyze the refractive error after IOL (Intra Ocular Lens) implantation in myopic patients and deduce the error that would have generated the use of different formulae.

Methods

We retrospectively analyzed the refractive outcome of 101 eyes of 69 myopic patients operated by phacoemulsification and IOL implantation between 2009 and 2011 at two different medical centers. All had AL (Axial Length) greater than 27mm. IOL power had been approximated prior to surgery by formulae obtained from non-contact laser biometer IOLMaster™ (Zeiss). We calculate deviation from emmetropia and the most accurate formula. 

Results

69.3% of the operated eyes had a residual refractive error within half diopter range, collecting 89.1% within the diopter of deviation. Average deviation from correct IOL power was +1.99D for HofferQ, +1.58D for Holladay; +1.31D for SRK-T, and +0.86D for Haigis. The differences were greater among formulas in the negative IOL group. 

Conclussion

To our knowledge, the Haigis formula calculates the most accurate IOL power in the great myopic. Constant customization should improve his accuracy.