Rodrigo França de Espíndola

Visual performance of an apodized diffractive multifocal intraocular lens with +3.00-d addition: 1-year follow-up.

PURPOSE To determine whether implantation of a multifocal intraocular lens (IOL) with a lower addition (+3.00 diopters [D]) at the lens plane results in better intermediate visual acuity 1 year after surgery compared with a multifocal IOL with higher addition (+4.00 D). METHODS This prospective, randomized, double-masked study included 80 eyes from 40 patients. Twenty patients were implanted bilaterally with the ReSTOR +3.00-D add IOL and 20 patients were implanted bilaterally with the ReSTOR +4.00-D add IOL. Primary outcome measures were distance, intermediate, and near visual acuity. Secondary outcomes were defocus curves, best reading distance, mesopic and photopic contrast sensitivity, quality of life, and spectacle independence. Monocular and binocular visual acuity were measured as uncorrected and corrected distance visual acuity at 4 m, uncorrected near and distance-corrected near visual acuity at 40 cm, and uncorrected intermediate visual acuity and distance-corrected intermediate visual acuity at 50, 60, and 70 cm. RESULTS Twelve months postoperatively, no statistically significant difference between groups in distance and near visual acuity was noted. The ReSTOR +3.00-D add group performed better than the ReSTOR +4.00-D add group at all intermediate distances studied. The ReSTOR +4.00-D group chose a reading distance 8 cm closer than the +3.00-D group. Both groups performed similarly with respect to contrast sensitivity, quality of life, and spectacle independence rates. CONCLUSIONS Patients implanted with a multifocal IOL with lower addition (ReSTOR +3.00 D) had better performance at intermediate distances compared with the ReSTOR +4.00-D add IOL with similar performance for distance and near visual acuity, contrast sensitivity, and quality of life.

Effects of blue light–filtering intraocular lenses on the macula, contrast sensitivity, and color vision after a long-term follow-up

PURPOSE: To evaluate the possible side effects and potential protection 5 years after implantation of an intraocular lens (IOL) with a blue‐light filter (yellow tinted). SETTING: Ophthalmology Department, University of São Paulo, São Paulo, Brazil. DESIGN: Prospective randomized clinical study. METHODS: Patients with bilateral visually significant cataract randomly received an ultraviolet (UV) and blue light–filtering IOL (Acrysof Natural SN60AT) in 1 eye and an acrylic UV light–filtering only IOL (Acrysof SA60AT) in the fellow eye. The primary outcome measures were contrast sensitivity, color vision, and macular findings 5 years after surgery. RESULTS: The study enrolled 60 eyes of 30 patients. There were no significant clinical or optical coherence tomography findings in terms of age‐related macular degeneration in any eye. There were no statistically significant differences in central macular thickness between the 2 IOL groups (P=.712). There were also no significant between‐group differences under photopic or scotopic conditions at any spatial frequency studied. No statistically significant differences in the color discrimination test were found between the 2 IOL groups (P=.674). CONCLUSIONS: After 5 years, there were no significant differences in color perception, scotopic contrast sensitivity, or photopic contrast sensitivity between the blue light–filtering (yellow‐tinted) IOL and the IOL with a UV‐light filter only (untinted). The potential advantage of the tinted IOL in providing protection to macular cells remains unclear. Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned.

Comparison of reading performance after bilateral implantation of multifocal intraocular lenses with +3.00 or +4.00 diopter addition

PURPOSE: To compare reading ability after cataract surgery and bilateral implantation of multifocal intraocular lenses (IOLs) with a +3.00 diopter (D) addition (add) or a +4.00 D add. SETTING: Department of Ophthalmology, University of São Paulo, São Paulo, Brazil. DESIGN: Prospective comparative study. METHODS: Patients scheduled for cataract surgery were randomly assigned to bilateral implantation of an aspheric AcrySof ReSTOR multifocal IOL with a +3.00 diopter (D) addition (add) or a +4.00 D add. The reading speed, critical print size, and reading acuity were measured binocularly with best correction using MNREAD acuity charts 6 months after surgery. Patients were tested with the chart at the best patient‐preferred reading distance and at 40 cm. Binocular uncorrected and best distance‐corrected visual acuities at far and near were also measured. RESULTS: The study enrolled 32 patients. At the best reading distance, the results were similar between the 2 IOL groups in all reading parameters. When tested at 40 cm, reading speed at all print sizes from 0.3 to 0.0 (all P<.001), critical print size (P<.001), and reading acuity (P = .014) were statistically significantly better in the +3.00 D IOL group than in the +4.00 D IOL group. Uncorrected and corrected visual acuities at far and near were similar between the 2 groups. CONCLUSION: Although the 2 IOL groups had similar performance in reading parameters, patients had to adjust to their best reading distance. The +3.00 D IOL performed better than the +4.00 D IOL at 40 cm. Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned.

Phacoemulsification versus extracapsular extraction: governmental costs

PURPOSE To evaluate the governmental costs of patients undergoing phacoemulsification and extracapsular cataract extraction at a public hospital in a developing country. METHODS A prospective study was conduced with 205 patients. The subjects were randomized for cataract surgery using either phacoemulsification or extracapsular cataract extraction techniques. RESULTS Of the 205 patients, 101 patients were submitted to phacoemulsificationand 104 patients were submitted to extracapsular cataract extraction. Brazilian Health Care System expenditures for the surgery and the postoperative period were US

Influência da correção cirúrgica da catarata na percepção laborativa

95.49 more in the phacoemulsification group than in the extracapsular cataract extractiongroup. If we take into account Social Security expenditures, then we estimate that the average difference for the total direct cost for the government for the surgery and the postoperative period for both procedures was US

Dificuldades de acesso ao tratamento de pacientes com indicação de cirurgia de catarata nos Sistemas de Saúde Público e Privado

50.91 or approximately half of the initial difference in cost for the phacoemulsification surgery. The total cost of cataract surgery for the government (excluding social security) was estimated at US

Cancelamento de cirurgias de catarata em um hospital público de referência

258.79 for extracapsular cataract extraction and US

A clinical comparison between DisCoVisc and 2% hydroxypropylmethylcellulose in phacoemulsification: a fellow eye study

309.70 for phacoemulsification per patient. Focusing only on working patients, the total cost was US

Ocular risk management in patients undergoing general anesthesia: an analysis of 39,431 surgeries

342.21 for phacoemulsification and US

Cirurgia de catarata realizada por residentes: avaliação dos riscos

587.71 for extracapsular cataract extraction, a difference of US