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Rotation can reduce astigmatic correction; if necessary lens repositioning should occur as early as possible prior to lens encapsulation. These may include some perceptions of halos or starbursts, as well as other visual symptoms.
As with other multifocal IOLs, there is a possibility that visual symptoms may be significant enough that the patient will request explant of the multifocal IOL. A reduction in contrast sensitivity as compared to a monofocal IOL may be experienced by some patients and may be more prevalent in low lighting conditions. Therefore, patients implanted with multifocal IOLs should exercise caution when driving at night or in poor visibility conditions.
Patients should be advised that unexpected outcomes could lead to continued spectacle dependence or the need for secondary surgical intervention e. As with other multifocal IOLs, patients may need glasses when reading small print or looking at small objects. In addition, patients should be warned that they will need to exercise caution when engaging in activities that require good vision in dimly lit environments, such as driving at night or in poor visibility conditions, especially in the presence of oncoming traffic.
It is possible to experience very bothersome visual disturbances, significant enough that the patient could request explant of the IOL. Prior to surgery, physicians should provide prospective patients with a copy of the Patient Information Brochure available from Alcon informing them of possible risks and benefits associated with these IOLs.
Download UVA spec sheet. Download BLF spec sheet. Evaluation of clarity characteristics in a new hydrophobic acrylic IOL. J Cataract Refract Surg. Mid-term and long-term clinical assessments of a new 1-piece hydrophobic acrylic IOL with hydroxyethyl methacrylate. Maxwell A, Suryakumar R. Long-term effectiveness and safety of a three-piece acrylic hydrophobic intraocular lens modified with hydroxyethyl-methacrylate: an open-label, 3-year follow-up study.
Clin Ophthalmol. Published Apr Success with this toric lens can be broken into a few areas. Surgeons should begin by calculating the spherical equivalent IOL power normally with the same optimized lens constant as for the SN60AT model. The spherical equivalent powers currently available range from Surgeons can also customize important variables to accommodate their preferences and their patients' needs for optimized outcomes.
First, surgeons enter basic information such as their name, the patient's name, and the operative eye. Second, they input data from manual keratometry the flat and steep K reading in diopters and the meridian and biometric results IOL spherical power as determined by the surgeons' preferred formula.
Finally, surgeons enter the estimated surgically induced cylinder and the location of the cataract surgery incision. Next, the calculator uses the input information to identify the model of Acrysof Toric IOL and spherical equivalent power that is best for each patient. In addition, it determines the optimal axis placement of the lens within the capsular bag.
Vector analysis compensates for surgically induced astigmatism in the calculation of IOL power and optimal axis location Figure 2. A vector is any measurement that has both magnitude and direction. For example, 2. Many surgeons do not consider the potential of clear corneal cataract incisions to induce astigmatism. The vector of the corneal wound depending on the incision's location, size, and architecture invariably changes the vector of the preoperative corneal astigmatism.
If a surgeon selects the amount of toric IOL power and axis placement based on preoperative keratometry, the postoperative result may be an astigmatic angular error, even in the absence of IOL rotation. Ophthalmologists who have implanted first-generation toric IOLs are all too familiar with the differences that can occur between the predicted and postoperative magnitude of astigmatism and its corresponding axis.
Because corneal astigmatism and astigmatism induced by corneal wounds can be considered vectors, they may be added together. Just as pilots may need to change power and direction to compensate for the wind, surgeons may also need to calculate a new toric IOL power and axis to compensate for wound-induced astigmatic changes. For example, an eye with a low degree of astigmatism approximately 1. Although this change may not appear significant, ignoring the subsequent shift in axis will produce an angular error of approximately 0.
These differences mean the toric power of the IOL will be off by 0. Such an incision typically induces 0. Ignoring the shift in axis induced by the incision would produce a residual angular error of approximately 0.
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