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Abstract(s)
Introdução: A multifocalidade é cada vez mais utilizada em cirurgia refrativa e procura ultrapassar um dos maiores desafios da área – a presbiopia. Nos últimos anos, várias lentes intraoculares (LIOs) multifocais têm sido desenvolvidas com a premissa de tentar garantir uma acuidade visual (AV) funcional para todas as distâncias. No entanto, para se conseguir independência de óculos, é igualmente importante corrigir o astigmatismo corneano significativo, que se estima estar presente em 30% dos doentes submetidos a cirurgia de catarata. Modelos mais recentes de LIOs, ao incorporarem um componente tórico, permitem ao cirurgião corrigir qualquer erro refrativo.
Objetivo: Analisar e comparar os resultados visuais e refrativos pós-operatórios após implantação de uma LIO asférica trifocal ou uma LIO multifocal asférica tórica em olhos com características biométricas e epidemiológicas equivalentes.
Métodos: Trata-se de um estudo retrospetivo comparativo, incluindo casos sequenciais não randomizados de pacientes operados entre novembro de 2012 e setembro de 2013. Os pacientes com presbiopia, astigmatismo corneano e motivação para a independência do uso de óculos foram submetidos a extração de cristalino transparente (ECT) com implante de LIO. Os pacientes foram divididos em 2 grupos: implantação de LIO asférica trifocal AT LISA® 839M - grupo 1 - ou implantação de LIO asférica tórica AT LISA® 909MP se astigmatismo corneano >0.75D - grupo 2. Os principais resultados estão relacionados com a melhor acuidade visual corrigida (MAVC) e sem correção (AVSC) para longe (PL) e para perto (PP) usando a escala logMAR, refração esférica e cilíndrica.
Resultados: Trinta e dois olhos (16 pacientes) foram incluídos no grupo 1 e 16 olhos (8 pacientes) no grupo 2. Observou-se uma melhoria significativa na AVSC PL (p <0.001) e na MAVC PL (p = 0.001). A AVSC PP média foi de 0.123 logMAR no grupo 1 e 0.130 logMAR no grupo 2. Um cilindro refrativo residual inferior a 1.00D foi encontrado em 86.7% dos casos com a LIO tórica.
Conclusões: As estudadas LIOs AT LISA® garantem uma excelente AVSC PP e MAVC PL funcional. A 909MP é eficaz na correção de astigmatismo corneano, proporcionando resultados visuais PP e PL tão favoráveis quanto a 839M.
Background: Multifocality is increasingly used in refractive surgery and seeks to overcome one of the biggest challenges in the area – presbyopia. In recent years, several multifocal intraocular lenses (IOLs) have been developed with the promise to try to ensure a functional visual acuity (AV) for all distances. However, to achieve spectacle independency, it is also important to correct the mean corneal astigmatism, which is estimated to be present in 30% of the patients undergoing cataract surgery. New models of IOLs, by incorporating a toric component, allows the surgeon to correct any refractive error. Purpose: To analyze and compare postoperative visual and refractive outcomes after implantation of an aspheric trifocal IOL or an aspheric toric multifocal IOL in eyes with equivalent biometric and epidemiologic characteristics. Methods: It is a comparative retrospective study, including sequential nonrandomized cases of patients operated between November 2012 and September 2013. Patients with presbyopia, corneal astigmatism and motivation for spectacle independency were submitted to refractive lens exchange (RLE) with IOL implantation. Patients were assigned in 2 groups: aspheric, trifocal AT LISA® 839M IOL implantation – group 1 - or aspheric, toric AT LISA® 909MP IOL implantation if corneal astigmatism >0.75D – group 2. Main outcomes were related to near and distance uncorrected and corrected visual acuity using logMar scale, spherical and cylindrical refraction. Results: Thirty-two eyes (16 patients) were included in group 1 and 16 eyes (8 patients) in group 2. It was observed significant improvement in uncorrected distance visual acuity (UDVA) (p<0.001) and corrected distance visual acuity (CDVA) (p=0.001). Mean uncorrected near visual acuity (UNVA) was 0.123 logMAR in group 1 and 0.130 logMAR in group 2. Residual refractive cylinder inferior to 1.00D was found in 86.7% of cases with the toric IOL. Conclusions: The studied AT LISA IOLs provided excellent functional UNVA and CDVA. The 909MP is effective in correcting corneal astigmatism, while providing distance and near vision outcomes as favorable as the 839M.
Background: Multifocality is increasingly used in refractive surgery and seeks to overcome one of the biggest challenges in the area – presbyopia. In recent years, several multifocal intraocular lenses (IOLs) have been developed with the promise to try to ensure a functional visual acuity (AV) for all distances. However, to achieve spectacle independency, it is also important to correct the mean corneal astigmatism, which is estimated to be present in 30% of the patients undergoing cataract surgery. New models of IOLs, by incorporating a toric component, allows the surgeon to correct any refractive error. Purpose: To analyze and compare postoperative visual and refractive outcomes after implantation of an aspheric trifocal IOL or an aspheric toric multifocal IOL in eyes with equivalent biometric and epidemiologic characteristics. Methods: It is a comparative retrospective study, including sequential nonrandomized cases of patients operated between November 2012 and September 2013. Patients with presbyopia, corneal astigmatism and motivation for spectacle independency were submitted to refractive lens exchange (RLE) with IOL implantation. Patients were assigned in 2 groups: aspheric, trifocal AT LISA® 839M IOL implantation – group 1 - or aspheric, toric AT LISA® 909MP IOL implantation if corneal astigmatism >0.75D – group 2. Main outcomes were related to near and distance uncorrected and corrected visual acuity using logMar scale, spherical and cylindrical refraction. Results: Thirty-two eyes (16 patients) were included in group 1 and 16 eyes (8 patients) in group 2. It was observed significant improvement in uncorrected distance visual acuity (UDVA) (p<0.001) and corrected distance visual acuity (CDVA) (p=0.001). Mean uncorrected near visual acuity (UNVA) was 0.123 logMAR in group 1 and 0.130 logMAR in group 2. Residual refractive cylinder inferior to 1.00D was found in 86.7% of cases with the toric IOL. Conclusions: The studied AT LISA IOLs provided excellent functional UNVA and CDVA. The 909MP is effective in correcting corneal astigmatism, while providing distance and near vision outcomes as favorable as the 839M.
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Keywords
Bifocal Cirurgia Refrativa Facoemulsificação Lente Intraocular Multifocal Trifocal