Abstract

Purpose: To investigate the impact of residual astigmatism on visual acuity (VA) after the implantation of a novel extended range of vision (ERV) intraocular lens (IOL) based on the correction of spherical and chromatic aberration. Method: The study enrolled 411 patients bilaterally implanted with the ERV IOL Tecnis Symfony. Visual acuity and subjective refraction were analyzed during the 4- to 6-month follow-up. The sample of eyes was stratified for four groups according to the magnitude of postoperative refractive astigmatism and postoperative spherical equivalent. Results: The astigmatism analysis included 386 eyes of 193 patients with both eyes of each patient within the same cylinder range. Uncorrected VAs for distance, intermediate and near were better in the group of eyes with lower level of postoperative astigmatism, but even in eyes with residual cylinders up to 0.75 D, the loss of VA lines was clinically not relevant. The orientation of astigmatism did not seem to have an impact on the tolerance to the residual cylinder. The SE evaluation included 810 eyes of 405 patients, with both eyes of each patient in the same SE range. Uncorrected VAs for distance, intermediate and near, were very similar in all SE groups. Conclusion: Residual cylinders up to 0.75 D after the implantation of the Tecnis Symfony IOL have a very mild impact on monocular and binocular VA. The Tecnis Symfony IOL shows a good tolerance to unexpected refractive surprises and thus a better “sweet spot”.

Highlights

  • The rate of enhancement to reduce residual astigmatism after cataract surgery with implantation of a MF intraocular lens (IOL) ranges from 5.24% to 23.66% depending on the study

  • Gundersen et al reported a significant rate of retreatments after multifocal intraocular lenses (MF IOLs) implantation (10.8%) over a sample of 416 eyes, most of which are due to reduced visual acuity (VA) secondary to residual astigmatism

  • This paper reports our experience about the impact of residual astigmatism on VA after the implantation of a novel extended range of vision (ERV) IOL based on the correction of spherical and chromatic aberration

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Summary

Introduction

Gundersen et al reported a significant rate of retreatments after MF IOL implantation (10.8%) over a sample of 416 eyes, most of which are due to reduced visual acuity (VA) secondary to residual astigmatism. These authors found no statistically significant differences in the impact of residual astigmatism on the visual outcome between different traditional MF IOL models [5]. The well-known potential complications of corneal refractive procedures, including the induction of higher-order aberrations (HOAs), and the secondary degradation of the retinal image may lead to dissatisfaction. This paper reports our experience about the impact of residual astigmatism on VA after the implantation of a novel extended range of vision (ERV) IOL based on the correction of spherical and chromatic aberration

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