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Toric IOLs: wavefront aberrometry and quality of life

University of Florence Department of Oto-Neuro-Ophthalmological Sciences Prof. U. Menchini. Toric IOLs: wavefront aberrometry and quality of life . Mencucci Rita Giordano Cristina, Stiko Ermelinda , Miranda Paolo, Eleonora Favuzza , Ugo Menchini.

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Toric IOLs: wavefront aberrometry and quality of life

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  1. UniversityofFlorence DepartmentofOto-Neuro-OphthalmologicalSciences Prof. U. Menchini Toric IOLs: wavefrontaberrometryand quality of life Mencucci Rita Giordano Cristina, StikoErmelinda, Miranda Paolo, Eleonora Favuzza, Ugo Menchini Authors do nothaveanyfinancial interest in the subjectmatterof the presentation

  2. Aimof the Study Implantationoftoricintraocularlenses (IOLs) isanoptionto compensate forcornealastigmatism in cataractpatients • To present the use of aberrometrical evaluation and quality of life test for the assessment of visual performance pre and post implantation of toric intraocular lenses

  3. Materials and Methods 60 cataractastigmaticpatients (cyl > 1,5 D) Standard uneventful 2.75 mm clear cornea phacoemulsification, incision on the steepestaxis Toricgroup - 36 patientsimplantedwithAlconAcrysofToricIOLs: 12 males, 24 females, meanage 73.9, (min 49 – max 86) Controlgroup - 24 patientsimplantedwithasphericAlconAcrysof SN60WF IOLs : 10 males , 14 females, meanage 77.1 (min 67 – max 86) OpticalBiometrywith Zeiss IOL Master (Holladay I Formula) CornealTopography Toriccalculation: www.acrysoftoriccalculator.com Follow up at least 3 months

  4. Materials and Methods Refractive and clinicaloutcome: Objectiverefraction: OPD OpticalPathDifferenceevaluation (Nidek OPD Scan II) UDVA Aberrometricalevaluation at 4.00 mm pupildiameter : Nidek OPD Scan II : Astigmatism RMS (ZernikePolinomial Z 2,2 Z2,-2) MTF Area Ratio; PSF (StrehlRatio) Qualityof life test: NEI-RQL 42

  5. ResultsOPD Refractiveoutcome (CylOpticalPower D) ** Cyl optical power (OPD) * ** = p<0.001 cyl pre op toric vs cyl postop toric Pupil diameter : 4 mm Target SE ( Zeiss IOL Master)= -0,25 Sphere ≤ ± 0,50 D

  6. ResultsUncorrectedDistanceVisualAcuity (UDVA) * = p<0.05 UDVA post op toric vs UDVA postop control Pupil diameter: 4 mm

  7. ResultsAstigmatismEvaluation - ZernikePolynomialZ 2,2 Z 2,-2 (Wavefronterror – microns) ** p<0.001 cyl post-op toric vs pre-op toric Pupil diameter 4 mm

  8. MTF evaluation: Area Ratio A/Bis the ratio between AVE and BMTF A/D is the ratio between AVE and Diffraction Limited H/B is the ratio between HOave and BMTF H/D is the ratio between HOave andl Diffraction Limited Area Ratio close to ONE means more image contrast.

  9. ResultsMTF Area ratio A/D (Average/Diffractionlimited) ** ** p<0.001 post op toric vs preop toric Pupil diameter 4 mm Area ratiocloserto ONE means more imagecontrast

  10. ResultsPSF (StrehlRatio) ** • The Point Spread Function (PSF) describes the light distribution on the retina of a point source. • It can beexpressedwith the Strehlratio, a measurementof the PSF peakheightover the peakheightfor the sameoptical system ifitisdiffractionlimited. ** p<0.001 post op toric vs preop toric Pupil diameter 4 mm

  11. Quality of lifeNEI-RQL 42TM Four main items, important in astigmatic patients: Clarity of visiontoricvs control postopp<0.001 Far vision toricvs control postopp<0.05 Glaretoricvs control postopp<0.05 Overall satisfaction toricvs control postopp=0.001

  12. Conclusions • Wavefrontaberrometryisanusefultoolto test optical and visual performance afterToricIOLsimplantation • The MTF and PSF data show a relevantbetteropticalquality in Toric IOL group in comparisonwithcontrolgroup, relatedtoastigmatismvaluecorrection • The NEI-RQL 42 qualityof life test is a sensitive instrumenttodetect the visualbenefitsofToricIOLs • Thereisanassociationofobjectiveoptical performance ofToricIOLswith a subjectiveimprovement in qualityof life

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