EyeWorld Asia-Pacific September 2011 Issue

September 2011 17 EW FEATURE In the toric group, UDVA was 20/40 or better in 19 eyes (95%), 20/32 (6/10) or better in 15 eyes (75%), and 20/25 (6/7.5) or better in 11 eyes (55%). In the relaxing incisions group, UDVA was 20/40 better in 17 eyes (85%), 20/32 or better in 12 eyes (60%), and 20/25 in 6 eyes (30%). Fifteen eyes (95%) achieved a CDVA of 20/32 or better in both groups. The toric IOL group achieved better mesopic contrast sensitivity in a glare situation. After surgery, 15% of patients in the toric group and 45% in the relaxing incision group required distance spectacles. “Because there was no difference in postoperative CDVA [corrected distance visual acuity] between the 2 groups, the better result in the toric IOL group is attributable to the lower residual refractive astigmatism,” Dr. Mingo-Botin reported. “Although the difference in mean UDVA between the 2 groups did not reach statistical significance, probably because of the small sample size and moderate level of corneal cylinder, there was a significant difference in the B values, reflecting the refractive advantage in the toric IOL group.” Dr. Mingo-Botin thinks elderly people in nighttime conditions will have better vision with the toric lens, thanks to its improved mesopic contrast sensitivity in glare circumstances. “Elderly people are the most affected by glare conditions at night, indicating that they might benefit from toric IOL implantation.” EW Editors’ note: Dr. Mingo-Botin has no financial interests related to the JCRS study. Dr. Weikert has financial interests with Alcon (Fort Worth, Texas, USA/Hünenberg, Switzerland). Contact information Mingo-Botin: davminbot@gmail.com Weikert: mweikert@bcm.tmc.edu a superimposed, out-of-focus image that varies depending on the pupil size,” Dr. McDonald said. “That is true of all diffractive multifocal lenses.” Giving up that much energy in the eye is problematic, especially if the eye later becomes symptomatic with macular degeneration, glaucoma, or vein occlusions. “With monovision, if you lose the sight in one eye or partial sight in one eye, you haven’t given away any of the person’s visual potential because of loss of optics,” Dr. McDonald said. The weaknesses of the monofocal approach are much the same as those of the multifocal approach, he said. “You have to hit your targets,” Dr. McDonald said. “You have to clean up refractive errors that are off more than 0.5 D of either sphere or cylinder.” Dr. McDonald, too, keeps the separation of the two eyes small. “We are down to –1.25 D,” he said. “At that difference, the only true difference between what you see in the focused eye and the out- of-focus eye is some loss of higher spatial frequencies in the out-of- focus eye, but in the mid and low spatial frequencies, 90% of the same information is there. With monovision, you don’t see with one eye and suppress and then see with the other eye. You actually see with both eyes.” Dr. McDonald said there are a small number of people who are strongly right- or left-eye dominant. Those people might have trouble adjusting to monovision. Dr. McDonald and colleagues are in the process of developing a neurocognitive quantitative test to help look for that issue. EW Reference J Cataract Refract Surg 2011; 37:446–453 Q 2011 ASCRS and ESCRS. Editors’ note: Dr. Barrett has no financial interests related to his comments. Dr. Davison has a The great from page 15 financial interest with Alcon. Dr. Logan has financial interests with AMO and Alcon. Dr. McDonald has financial interests with Bausch & Lomb (Rochester, NY, USA), Hoya Surgical Optics (Chino Hills, Calif., USA), and STAAR Surgical (Monrovia, Calif., USA/Nidau, Switzerland). Contact information Barrett: barrett@cyllene.uwa.edu.au Davison: 800-542-7957, jdavison@wolfeclinic.com Logan: 562-938-9945, dklogan@atlantiseyecare.com McDonald: 479-521-2555, mcdonaldje@mcdonaldeye.com OCULUS Pentacam ® The indispensable tool for anterior segment analysis Whether keratoconus, cataract or other corneal diseases - the OCULUS Pentacam ® detects it! Various software modules such as the Belin/Ambrosio Enhanced Ectasia display, advanced IOL calculation and many others support your daily work precisely and efficiently. Oculus Asia Ltd. Hong Kong Tel. +852 2987 1050 • Fax +852 2987 1090 www.oculus.de • info@oculus.hk www.pentacam.com Please visit us at the APACRS – Booth No. B15/16