Purpose To compare the anti-inflammatory efficacy of ketorolac of tromethamine 0.4% and nepafenac 0.1% eye drops for prophylaxis of cystoid macular oedema (CME) after small-incision cataract extraction.
Nota Editorial: Depois de concluída a análise do artigo sob sigilo editorial e com a anuência dos Drs. Paulo Gilberto Jorge Fasdel e Breno Barth sobre a divulgação de seus nomes como revisores, agradecemos suas participações neste processo. Objetivos:Comparar o desempenho visual e a análise de frente de onda entre as lentes intra-oculares (LIOs) multifocal difrativa Tecnis ® ZM900 asférica e AcrySof ® ReSTOR ® esférica SN60D3. Métodos: Trata-se de estudo prospectivo comparativo que incluiu 78 olhos de 39 pacientes. A avaliação oftalmológica contou com medida da acuidade visual para longe, intermediária e curta distância, sem correção e com a melhor correção óptica, teste de sensibilidade ao contraste e análise de frente de onda por meio do aberrômetro OPD-Scan. Resultados: Acuidade visual para longe e para perto sem correção óptica e análise de aberrometria foram estatisticamente semelhantes em relação a ambas as LIOs; já a visão intermediária e a sensibilidade ao contraste em condições fotópicas revelaram diferença estatisticamente significante entre as duas lentes a favor da Tecnis ZM900. Conclusão: Ambas as lentes intra-oculares promoveram excelente visão para longe e para perto em situações de alto contraste. A LIO Tecnis multifocal necessita de menos luminosidade para visão em situações de alto contraste, apresenta menos aberrações ópticas e melhor visão intermediária que a LIO ReSTOR. RESUMO INTRODUÇÃOUm dos principais desafios da moderna cirurgia de catarata é a recuperação da capacidade visual para perto. Muitas formas de abordagem com o objetivo de correção da presbiopia foram tentadas, como monovisão e miopização contralateral (1)(2) . As lentes intra-oculares (LIOs) multifocais tentam compensar a eventual perda de estereopsia e visão binocular que limitavam as estratégias usadas com as LIOs monofocais. Apesar de se mostrarem efetivas na visão de perto e de longe, uma limitação destas lentes, sejam refrativas ou difrativas, é a dispersão de energia, que leva à formação de halos e "glare" e à redução da sensibilidade ao contraste (1)(2)(3)(4)(5)(6)(7) . As modificações no cristalino que ocorrem com o passar do tempo levam à diminuição da sensibilidade ao contraste (8) . A qualidade da visão é ainda mais prejudicada quando se desenvolve catarata. Ao se submeterem à facectomia, os pacientes têm expectativas de melhora da sua visão, com conseqüente
Purpose: To compare the optical performance and visual outcomes between two diffractive multifocal lenses: AMO Tecnis® ZMB00 and AcrySof® ReSTOR® SN6AD1. Methods: This prospective, non-randomized comparative study included the assessment of 74 eyes in 37 patients referred for cataract surgery and candidates for multifocal intraocular lens implants. Exclusion criteria included existence of any other eye disease, previous eye surgery, high axial myopia, preoperative corneal astigmatism of >1.00 cylindrical diopter (D), and intraoperative or postoperative complications. Ophthalmological evaluation included the measurement of uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), distance-corrected near visual acuity (DCNVA), and distance-corrected intermediate visual acuity (DCIVA), with analysis of contrast sensitivity (CS), wavefront, and visual defocus curve. Results: Postoperative UDVA was 0.09 and 0.08 logMAR in the SN6AD1 and ZMB00 groups, respectively (p=0.868); postoperative CDVA was 0.04 and 0.02 logMAR in the SN6AD1 and ZMB00 groups, respectively (p=0.68); DCIVA was 0.17 and 0.54 logMAR in the SN6AD1 and ZMB00 groups, respectively (p=0.000); and DCNVA was 0.04 and 0.09 logMAR in the SN6AD1 and ZMB00 groups, respectively (p=0.001). In both cases, there was an improvement in the spherical equivalent and UDVA (p<0.05). Under photopic conditions, the SN6AD1 group had better CS at low frequencies without glare (p=0.04); however, the ZMB00 group achieved better sensitivity at high frequencies with glare (p=0.003). The SN6AD1 and ZMB00 lenses exhibited similar behavior for intermediate vision, according to the defocus curve; however, the ZMB00 group showed a shorter reading distance than the SN6AD1 group. There were no significant differences regarding aberrometry between the two groups. Conclusion: Both lenses promoted better quality of vision for both long and short distances and exhibited a similar behavior for intermediate vision. The SN6AD1 and ZMB00 groups showed better results for CS under photopic conditions at low and high spatial frequencies, respectively. Keywords
The aim of this study was to compare the visual outcomes and subjective visual quality between bilateral implantation of an extended depth of focus intraocular lens, J&J Vision Tecnis Symfony ® ZXR00 (Group A) and bilateral implantation of a diffractive trifocal intraocular lens, Alcon Acrysof IQ PanOptix ® TNFT00 (Group B). Methods: This prospective, nonrandomized, comparative study of consecutive cases assessed 52 eyes of 26 patients operated on by the same surgeon (WTH) and binocularly implanted with multifocal intraocular lenses between May 2016 and July 2018. Binocular visual acuity for far, intermediate and near was tested in all cases. Ophthalmological evaluation included the measurement of binocular uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected near visual acuity (UNVA) at 40 cm, uncorrected intermediate visual acuity (UIVA) at 70 cm, monocular visual defocus curve and the quality of life (QoL) questionnaire, National Eye Institute Visual Functioning Questionnaire-25 (NEI-VFQ 25). Results: Postoperative UDVA was 0.00 and 0.09 logMAR (P<0.001), UIVA was 0.20 and 0.39 logMAR (P<0.001) and UNVA was 0.16 and −0.01 logMAR (P<0.001) in groups A and B, respectively; postoperative CDVA was −0.05 and 0.06 logMAR (P<0.001) in groups A and B, respectively. Conclusion: Both groups reported good subjective quality of vision regarding long, intermediate and short distances. Group A had a better performance for binocular UDVA, UIVA at 70 cm and CDVA, while regarding the monocular defocus curve, Group A outperformed Group B for long distances. Furthermore, Group B surpassed it in the short to very short distances, between the range of ≥2.00 D to 5.00 D of vergence. While Group A had a better performance regarding the vergences between 0.00 and 1.00 D (P<0.05) and at the vergence of +2.50 D (P=0.007). Group B outran Group A for UNVA at 40 cm.
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