Patient Satisfaction Following Cataract Extraction and IOL Implantation
Patient Satisfaction Following Cataract Extraction and IOL Implantation
Purpose. To determine vision quality when testing two acrylic intraocular lenses (IOLs), AcrysofIQ and AcrysofSingle-Piece, after routine cataract extraction and IOL implantation.
Setting. Storm Eye Institute and Magill Research Center for Vision Correction, Medical University of South Carolina, Charleston, SC, USA.
Methods. Prospective, randomized, double-masked study that included 53 eyes of 27 patients who underwent bilateral cataract extraction and IOL implantation. Patients were randomly divided into two groups depending on the type of IOL implanted: AcrysofIQ or AcrysofSingle-Piece. Preoperative, 1- and 3-month postoperative evaluations included ETDRS visual acuity, photopic contrast sensitivity, pupil size, wavefront testing, and a subjective questionnaire. Comparisons between the two groups and comparisons to baseline were made at each visit. P<0.05 was considered statistically significant.
Results. Preoperative, statistically significant differences were evident in response to the subjective questionnaire (near activities, driving dimensions, and overall score) between the two groups. Postoperatively there was a greater increase in contrast sensitivity at 1 and 3 months in the AcrysofIQ group when compared to baseline. Patients with AcrysofIQ IOL had a significant reduction in total high-order aberrations (HOA) and spherical aberration (SA) when compared to those patients with AcrysofSingle-Piece at 1 and 3 months and to baseline. Postoperative patient satisfaction showed no difference among the groups.
Conclusion. The use of a new aspheric acrylic IOL may improve the quality of vision as a result of the reduction of total HOA and SA.
Over the years, the cataract extraction techniques have evolved from intracapsular extraction to modern phacoemulsification. Different materials and designs are available, permitting implantation through smaller, sutureless incisions as well as foldable optics that permit larger optical zones to be used to minimize glare, among other things. However, despite a successful cataract surgery with IOL implantation and adequate refractive outcome, patients often complain about visual side effects (ie, ghost images, glare, and halos) and late onset, reduced visual acuity. Additionally, contrast sensitivity may be decreased following cataract surgery and IOL implantation, which can be influenced by optic design, dimension, and spectral transmission characteristics, all optical qualities of the IOL.
Wavefront analysis is currently used to measure aberrations of the entire optical system. This technology is widely used in corneal refractive surgery, with successful outcomes. With the introduction of wavefront analysis, a new tool is available to re-design and study the performance of IOLs. The goal is to improve the optical quality of pseudophakic eyes, therefore, improving patients' quality of life.
The purpose of this study is to compare the quality of vision provided by two different acrylic IOLs, an aspheric IOL (AcrysofIQ SN60WF, Alcon Laboratories, Ft. Worth, TX, USA) and a spherical IOL (AcrysofSingle-Piece SA60AT, Alcon Laboratories, Ft. Worth, TX, USA), implanted after routine cataract extraction by (1) determining differences in spherical aberration (SA) and other high-order aberrations (HOA), (2) establishing differences in photopic contrast sensitivity, and (3) evaluating a subjective questionnaire.
Purpose. To determine vision quality when testing two acrylic intraocular lenses (IOLs), AcrysofIQ and AcrysofSingle-Piece, after routine cataract extraction and IOL implantation.
Setting. Storm Eye Institute and Magill Research Center for Vision Correction, Medical University of South Carolina, Charleston, SC, USA.
Methods. Prospective, randomized, double-masked study that included 53 eyes of 27 patients who underwent bilateral cataract extraction and IOL implantation. Patients were randomly divided into two groups depending on the type of IOL implanted: AcrysofIQ or AcrysofSingle-Piece. Preoperative, 1- and 3-month postoperative evaluations included ETDRS visual acuity, photopic contrast sensitivity, pupil size, wavefront testing, and a subjective questionnaire. Comparisons between the two groups and comparisons to baseline were made at each visit. P<0.05 was considered statistically significant.
Results. Preoperative, statistically significant differences were evident in response to the subjective questionnaire (near activities, driving dimensions, and overall score) between the two groups. Postoperatively there was a greater increase in contrast sensitivity at 1 and 3 months in the AcrysofIQ group when compared to baseline. Patients with AcrysofIQ IOL had a significant reduction in total high-order aberrations (HOA) and spherical aberration (SA) when compared to those patients with AcrysofSingle-Piece at 1 and 3 months and to baseline. Postoperative patient satisfaction showed no difference among the groups.
Conclusion. The use of a new aspheric acrylic IOL may improve the quality of vision as a result of the reduction of total HOA and SA.
Over the years, the cataract extraction techniques have evolved from intracapsular extraction to modern phacoemulsification. Different materials and designs are available, permitting implantation through smaller, sutureless incisions as well as foldable optics that permit larger optical zones to be used to minimize glare, among other things. However, despite a successful cataract surgery with IOL implantation and adequate refractive outcome, patients often complain about visual side effects (ie, ghost images, glare, and halos) and late onset, reduced visual acuity. Additionally, contrast sensitivity may be decreased following cataract surgery and IOL implantation, which can be influenced by optic design, dimension, and spectral transmission characteristics, all optical qualities of the IOL.
Wavefront analysis is currently used to measure aberrations of the entire optical system. This technology is widely used in corneal refractive surgery, with successful outcomes. With the introduction of wavefront analysis, a new tool is available to re-design and study the performance of IOLs. The goal is to improve the optical quality of pseudophakic eyes, therefore, improving patients' quality of life.
The purpose of this study is to compare the quality of vision provided by two different acrylic IOLs, an aspheric IOL (AcrysofIQ SN60WF, Alcon Laboratories, Ft. Worth, TX, USA) and a spherical IOL (AcrysofSingle-Piece SA60AT, Alcon Laboratories, Ft. Worth, TX, USA), implanted after routine cataract extraction by (1) determining differences in spherical aberration (SA) and other high-order aberrations (HOA), (2) establishing differences in photopic contrast sensitivity, and (3) evaluating a subjective questionnaire.
