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To evaluate reliability and global indices parameters from standard automated perimetry (SAP) in normal eyes undergoing phacoemulsification cataract surgery with implantation of trifocal or extended depth of focus intraocular lens (IOL).Prospective study to evaluate the effect of trifocal IOL AcrySof IQ PanOptix® and extended depth of focus intraocular lens (EDOF) Tecnis Symfony® IOL implantation on visual field parameters. Patients underwent SAP pre- and postoperatively. Reliability indices (false negative rate-FN, false positive rate-FP), global indices (foveal sensitivity threshold, visual field index-VFI, standard pattern deviation-PSD, mean deviation MD) and test duration were analyzed.A total of 23 eyes from 13 patients were in the trifocal IOL group and a total of 22 eyes from 14 patients were in the EDOF group. The following results were obtained by analyzing pre- and postoperative SAP of EDOF IOL: the rate of change of FN was 1.95/1.41% (p = 0.61); FP 1.64/1.27 (p = 0.60); MD - 1.60/- 1.08 dB (p = 0.15); foveal sensitivity was 34.5/33.9 dB (p = 0.41); VFI 98.5/98.4% (p 0.99); PSD 1.85/1.86 (p = 0.07); and for test duration 305.81/298.36 s (p = 0.35); all respectively. Analysis of pre- and postoperative parameters of trifocal IOL were the rates of change of FN 1.22/1.83% (p = 0.29); FP 1.65/1.48% (p = 0.95); MD - 1.55/- 1.37 dB (p = 0.19); foveal sensitivity 33.9/34.9 dB (p = 0.47); VFI 98.6/98.3% (p = 0.62); PSD 1.58/2.05 (p = 0.02); and test duration 297.17/298.57 s (p = 0.87); all respectively.We identified a change in the PSD parameters in the trifocal IOL group. No other significant changes were identified in SAP parameters after implantation of trifocal AcrySof IQ PanOptix® and EDOF Tecnis Symfony® IOL. Longitudinal evaluation showed no changes in SAP after Trifocal and EDOF IOL implantation in normal subjects.

Background: The implantation of the intraocular lens (IOL) is still subject to error and complication, as it can result in traumatic opening of the IOL leading to rupture of the posterior capsule and zonular dialysis, it takes time to train paramedic teams to assemble such IOLs with the manual injectors. Moreover, there is a potential risk of comtamination and endophthalmitis as there is manipulation of the IOL and cartridge. The preloaded IOLs tend to reduce those unwanted results and may optimize the surgical time. Purpose: The aim of this study is to compare the effectiveness and implantation time between three injectors and three intraocular lenses, two pre-loaded and one conventional. Methodology: Videos of thirty patients undergoing cataract surgery from December 2019 to December 2020 at the Hospital Oftalmologico de Brasilia (HOB), Brasilia, Brazil were included in this observational, analytical retrospective study, non randomized. All patients had their surgeries recorded, from which the time of injection and opening of the intraocular lens (IOL) was extracted, 20 eyes were implanted with preloaded intraocular lens, and 10 eyes with conventional IOL implant. The patients were divided into three groups with similar eye characteristics. The first received the AutonoMeTM (CE) injector with the Clareon® IOL, the second the IsertTM injector (I) with the Hoya® IOL, and the third was injected with Johnson & Johnson Platinum 1 Series injector used to deliver Sensar® One AAB00 lens. The Welch test and Tukey’s Post Hoc test were used in the statistical analysis. Results: It was observed that there was a statistical significance regarding the presence of a haptic stuck (5 Clareon vs 0 Sensar and Hoya), between the mean opening time of the IOL optics Sensar One, Hoya and Clareon (25.00 vs 31.40 vs 11.70 s, p < 0.001) and between the total time (the injection time more the opening time of the IOL) in relation to Hoya and Clareon lenses (39.50 s vs 19.60 s, p < 0.001); the total time of the Sensar IOL was 31.30 s. The opening time of the IOL optics was significantly longer for the Sensar One and Hoya groups compared to Clareon group, and the total time of Hoya group was significantly longer compared to the total time of the Clareon group. Conclusion: The study demonstrated that the choice of injector and IOL set can significantly affect the total time of IOL implantation. However, there was no difference regarding complications and collateral damage depending on the set chosen for the implant.

Purpose 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, JJ postoperative CDVA was -0.05 and 0.06 logMAR (P

Purpose The aim of this study was to evaluate the influence of four different types of speculums on aberrometry reading (OPD SCAN III [OPD]) and on intraoperative aberrometry reading (optiwave response analyzer, ORA). Patients and methods This prospective, controlled, comparative study of consecutive cases included the evaluation of five eyes of five patients with monofocal intraocular lens (IOL) implantation. Seventeen measures were performed on each patient: for each speculum, there were two measurements on the OPD and another two on ORA with four different types of blepharostats. A control measure was performed on the without blepharostat in the dominant eye of each patient, therefore totalizing 85 measurements. The measures with the blepharostats were as follows: without pressure (WF) or passive measure and after pressure (AF) or active measure to close the eye. The speculum used in all patients was as follows: open-edged wire (Barraquer); threaded with open blade (Lieberman), with 21 mm aperture; wired with solid blade (Barraquer); and threaded with solid blade (Lieberman) with 21 mm opening. An evaluation of the objective refractive data from the OPD and ORA and the corneal astigmatism from the OPD was performed. Results Spherical equivalent (SE) of the OPD with the use of blepharostat compared to the OPD without speculum presented only 37.5% of results without statistical significance. Regarding the SE of ORA with speculum usage, compared to the OPD without blepharostat, only 12.5% were not significant. Regarding the accuracy of the ORA refractive axis with the use of blepharostats, all results presented statistical significance. Conclusion Thus, in the present study, we reached the conclusion between the studied blepharostats that the most suitable for use in the aphakic and pseudophakic capture of the ORA is the open blade threaded blepharostat (Lieberman).

Mario Augusto Pereira Dias Chaves,1–3 André Lins de Medeiros,1,2 César Martins Cortez Vilar,1,2,4 Klayne Rafaella Pereira Magalhães,2 Michelle Rodrigues Gonçalves,3 Patrick Frenzel de Moraes Tzelikis,1,2,5 Wilson Takashi Hida,1,2,5,6 Pedro Carlos Carricondo,2,5 Milton Ruiz Alves2,5 1Brasília Ophthalmologic Hospital (HOB), Department of Cataract, João Pessoa, Paraíba, Brazil; 2Renato Ambrosio Ophthalmologic Study Center (CEORA), Brasília, Federal District, Brazil; 3Provisão Paraíba Ophthalmologic Hospital, João Pessoa, Paraíba, Brazil; 4Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, TX, USA; 5São Paulo University School of Medicine (FM-USP), Department of Ophthalmology, São Paulo, Brazil; 6São Paulo Federal University of School of Medicine (UNIFESP), Department of Ophthalmology, São Paulo, Brazil Purpose: To assess the stability and reliability of femtosecond laser-assisted cataract surgery (FLACS) incisions design and dimensions using anterior segment optical coherence tomography (AS-OCT) imaging.Setting: Renato Ambrósio Ophthalmologic Study Center from Hospital Oftalmológico de Brasília, Brasília, Brazil.Design: Prospective nonrandomized controlled case series.Methods: Eyes undergoing FLACS with triplanar main temporal clear corneal incision (CCI) were evaluated at the end of the case. Eyes that required any incision hydration, surgical complications or lacked follow-up were excluded. The AS-OCT was performed after femtosecond delivery; at the end of the case; at 1 day and at 30 days after surgery. Data of pachymetry, endothelial and epithelial gaps, Descemet detachment and CCI architecture were compared.Results: Eleven eyes from 11 patients completed follow-up. Corneal thickness was statistically different between after femtosecond delivery and the end of the case (P-value

Purpose To compare intraoperative parameters between venturi and peristaltic pump in WhiteStar Signature® phacoemulsification machine using the bevel-down technique. Setting Hospital Oftalmologico de Brasilia, Brasilia, Federal District, Brazil. Design Prospective, comparative, patient-masked study. Methods Three hundred eyes were randomly assigned to have a phacoemulsification procedure with WhiteStar Signature® using either peristaltic (n=150 eyes) or venturi (n=150 eyes) pumps by a single surgeon (WTH). Elliptical ultrasound setting and prefracture (prechop or preslice) techniques were used in all cases. Cataract nucleus density was graded using lens opacities classification system III and Pentacam Nucleus Staging classification. Clinical measurements included preoperative- and postoperative- corrected visual acuity, preoperative and 2-month postoperative endothelial cell counts, and preoperative and 1-day postoperative central corneal thickness. Intraoperative measurements at the end of the case were phaco time, fluid used, total case time, and Efx energy. Results There were no statistically significant differences between groups regarding age, cataract density, and phaco time (P>0.05). Intraoperatively, we observed significantly less ultrasound energy (P=0.011), case time (P=0.0001), and balanced saline solution (P=0.001) usage in the venturi group. Clinically, both fluidic settings can provide similar clinical outcomes and visual recovery, regarding corrected distance visual acuity, endothelial cell count, and central corneal thickness. Conclusion Our data show that to minimize fluid use, case time, and energy with the prefracture technique, the venturi pump was the most efficient system and was statistically superior to peristaltic pump.

PURPOSE: To clinically evaluate visual performance of the AcrySof IQ PanOptix TFNT00 and AT LISA tri 839MP intraocular lenses (IOLs) in binocular visual acuity (VA) and to characterize low-contrast visual performance at 6 months postimplantation. SETTING: Multicenter, 15 sites. DESIGN: Prospective, parallel-group, randomized, double-masked, postmarketing clinical study. METHODS: Binocular uncorrected distance (UDVA, 4 m), intermediate (UIVA, 60 cm), and near (UNVA, 40 cm) visual acuities and binocular defocus curves were evaluated under photopic lighting conditions. Photopic and mesopic contrast sensitivities with and without glare were assessed. RESULTS: The study included 182 subjects (62% women; mean age, 66 ± 9.4 years) who were implanted bilaterally with the TFNT00 IOL (n = 93) or 839MP IOL (n = 89), and binocular VA was evaluated 4 to 6 months (120-180 days) postimplantation. The TFNT00 IOL group showed superior visual outcomes compared with the 839MP IOL group in binocular UIVA (P = .001) and UNVA (P = .003) and noninferior outcomes in UDVA (95% CI, -0.023 to 0.041; upper limit

Purpose: To compare the postoperative refractive predictability of IOLMaster 500 and Pentacam HR on the basis of keratometry and anterior chamber depth values in eyes with an indication for multifocal intraocular lens (IOL) implantation. Methods: This was a retrospective study conducted on 118 eyes treated with phacoemulsification and multifocal intraocular lens implantation. Only the eyes that achieved emmetropia in the dynamic refraction performed on postoperative day 30 were included. Haigis’ formula was used in each case to calculate the intraocular lens power, and the intraocular lens with the target refraction closest to emmetropia was implanted. Four lens calculation scenarios were tested by combining keratometry and anterior chamber depth measurements obtained using the two devices. Results: IOLMaster 500 and Pentacam HR differed with regard to mean keratometry (D 0.07 ± 0.03 D; p=0.0065) and anterior chamber depth (D 0.08 ± 0.01 mm; p

To assess the clinical outcomes after implantation of a new 340-degree arc length intrastromal corneal ring segment (ICRS) aided by the femtosecond laser in postkeratoplasty patients after a 12-month follow-up.Private practice, Brasilia, Brazil.Prospective case series.Eyes with previous keratoplasty had ICRS implantation assisted by femtosecond laser. The primary outcome measure was the change in the uncorrected distance visual acuity (UDVA) 12 months postoperatively. The secondary outcome measures were the corrected distance visual acuity (CDVA), refraction, and corneal tomography 1, 3, 6, and 12 months postoperatively. The astigmatism results were analyzed using vector analysis through the double-angle polar plot.Of the 18 patients, 7 (38.9%) were men, and 11 (61.1%) were women. The mean UDVA was 20/250 (1.15 logarithm of the minimum angle of resolution [logMAR]) before implantation and 20/70 (0.54 logMAR) at the last follow-up (P.001). The mean CDVA improved from 20/35 (0.26 logMAR) to 20/25 (0.10 logMAR) (P.001). The mean spherical equivalent and astigmatism components were significantly reduced after ICRS implantation. The mean corneal astigmatism decreased from 5.55 ± 2.29 D preoperatively to 3.92 ± 1.82 D postoperatively (P.001). The CDVA remained the same or improved in 19 of 20 eyes and decreased by 1 line in 1 patient. There were no surgical complications.A new ICRS with a 340-degree arc length was effective in treating postkeratoplasty eyes, improving visual acuity and reducing corneal astigmatism.

André Lins de Medeiros,1–4 André Gustavo de Araújo Rolim,1,2 Antonio Francisco Pimenta Motta,2,5 Bruna Vieira Ventura,3,6 César Vilar,1,2,7 Mário Augusto Pereira Dias Chaves,1–3,8 Pedro Carlos Carricondo,2,5 Wilson Takashi Hida1,2,5 1Cataract Department, Hospital Oftalmológico de Brasília, 2Cataract Department, Centro de Estudos Oftalmológicos Renato Ambrósio, Brasília,3Cataract Department, Fundação Altino Ventura, Recife, Brazil; 4Cataract Department, University of Edinburgh, Edinburgh, UK; 5Cataract Department, Universidade de São Paulo, São Paulo, 6Cataract Department, Hospital de Olhos de Pernambuco, Recife, 7Cataract Department, Hospital de Olhos Francisco Vilar, Teresina, 8Cataract Department, ProVisão, João Pessoa, Brazil Purpose: The purpose of this study was to compare the visual outcomes and subjective visual quality between bilateral implantation of a diffractive trifocal intraocular lens, Alcon Acrysof IQ® PanOptix® TNFT00 (group A), and blended implantation of an extended depth of focus lens, J&J Tecnis Symfony® ZXR00 with a diffractive bifocal intraocular lens, J&J Vision Tecnis® ZMB00 (group B).Methods: This prospective, nonrandomized, consecutive, comparative study included the assessment of 40 eyes in 20 patients implanted with multifocal intraocular lens. Exclusion criteria were existence of any corneal, retina, or optic nerve disease, previous eye surgery, illiteracy, previous refractive surgery, high axial myopia, expected postoperative corneal astigmatism of >1.00 cylindrical diopter (D), and intraoperative or postoperative complications. Binocular visual acuity was tested in all cases. Ophthalmological evaluation included the measurement of uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected near visual acuity (UNVA), and uncorrected intermediate visual acuity (UIVA), with the analysis of contrast sensitivity (CS), and visual defocus curve.Results: Postoperative UDVA was 0.01 and −0.096 logMAR (p

PURPOSE: To compare the accuracy of Optiwave Refractive Analysis (ORA) intraoperative aberrometry (Alcon Laboratories, Inc., Fort Worth, TX) with preoperative biometry in predicting residual refractive error after cataract surgery in eyes that underwent radial keratotomy. METHODS: This was a prospective consecutive case series of patients with cataract and prior radial keratotomy. Each patient underwent a preoperative intraocular lens (IOL) power calculation using partial coherence interferometry (IOLMaster version 5; Carl Zeiss Meditec, Jena, Germany). For each eye, the Barrett True-K formula was used to select an IOL targeting emmetropia. Residual refractive error was predicted preoperatively using the SRK/T, Hoffer Q, Haigis, and Holladay formulas 1 and 2, and the ORA intraoperatively. Between 8 and 12 weeks after cataract extraction with IOL implantation, the postoperative refraction was compared with the preoperative and intraoperative predictions. RESULTS: The study comprised 52 eyes of 34 patients. The median absolute errors associated with each method were as follows: Barrett True-K formula (0.34), ORA aberrometer (0.53), and SRK/T (0.54), Hoffer Q (0.51), Haigis (0.54), SRK/T (0.57), and Holladay formulas 1 and 2 (0.44) ( P = .08). The proportion of patients within ±0.50 diopters of the predicted error was 63.5%, 48.1%, 44.2%, 48.1%, 53.8%, 36.5%, and 57.7%, respectively ( P = .03). No statistically significant difference was observed in the number of eyes with hyperopic outcomes ( P = .68). CONCLUSIONS: In eyes with prior radial keratotomy surgery, the ORA aberrometer performance was similar to the Barrett True-K formula and all of the other established formulas, with no significant difference between median absolute error and mean absolute error. The Barrett True-K formula produced significantly more eyes within ±0.50 diopters than the SRK/T, Hoffer Q, and Holladay 1 formulas. [ J Refract Surg. 2019;35(10):656–661.]

Purpose To compare intraoperative parameters between venturi and peristaltic pump in WhiteStar Signature® phacoemulsification machine using the bevel-down technique. Setting Hospital Oftalmológico de Brasília, Brasília, Federal District, Brazil. Design Prospective, comparative, patient-masked study. Methods Three hundred eyes were randomly assigned to have a phacoemulsification procedure with WhiteStar Signature® using either peristaltic (n=150 eyes) or venturi (n=150 eyes) pumps by a single surgeon (WTH). Elliptical ultrasound setting and prefracture (prechop or preslice) techniques were used in all cases. Cataract nucleus density was graded using lens opacities classification system III and Pentacam Nucleus Staging classification. Clinical measurements included preoperative- and postoperative- corrected visual acuity, preoperative and 2-month postoperative endothelial cell counts, and preoperative and 1-day postoperative central corneal thickness. Intraoperative measurements at the end of the case were phaco time, fluid used, total case time, and Efx energy. Results There were no statistically significant differences between groups regarding age, cataract density, and phaco time (P>0.05). Intraoperatively, we observed significantly less ultrasound energy (P=0.011), case time (P=0.0001), and balanced saline solution (P=0.001) usage in the venturi group. Clinically, both fluidic settings can provide similar clinical outcomes and visual recovery, regarding corrected distance visual acuity, endothelial cell count, and central corneal thickness. Conclusion Our data show that to minimize fluid use, case time, and energy with the prefracture technique, the venturi pump was the most efficient system and was statistically superior to peristaltic pump.

To compare the antiinflammatory efficacy of topical nepafenac 0.3% for prophylaxis of macular edema after cataract extraction.São Paulo University, São Paulo, Brazil.Prospective randomized clinical trial.Patients with bilateral cataract were included in this study. Each patient was assigned randomly to receive nepafenac 0.3% drops in 1 eye and a placebo in the fellow eye. The primary outcome measure was the change in the mean spectral-domain optical coherence tomography central subfield thickness 5 weeks postoperatively. The secondary outcome measures were the total macular volume 1, 5, and 12 weeks postoperatively; the percentage of patients in both groups who developed macular edema, and the corrected distance visual acuity within 5 weeks and 12 weeks after cataract surgery.The study comprised 224 eyes of 112 patients. For all retinal thickness measurements, a significant increase in both groups was detected starting from the first postoperative week until 12 weeks. At 5 weeks, there was a statistically significant difference in central subfield thickness and total macular volume between the nepafenac group and control group (P = .01 and P .001, respectively). At the fifth postoperative week, no eye in the nepafenac group and 4 eyes (3.57%) in the control group had macula edema, highlighting a trend toward a greater incidence in the control group. The between-group differences in visual outcomes were not statistically significant.Used prophylactically after cataract surgery, nepafenac 0.3% was efficacious in reducing macular thickness compared with a placebo 5 weeks postoperatively, without a difference in final visual acuity.

César Vilar,1,2 Wilson Takashi Hida,1–3 André Lins de Medeiros,1,2 Klayny Rafaella Pereira Magalhães,2 Patrick Frensel de Moraes Tzelikis,1,2 Mario Augusto Pereira Dias Chaves,2,4 Antônio Francisco Pimenta Motta,2,3 Pedro Carlos Carricondo,1–3 Milton Ruiz Alves,3 Walton Nosé5 1Cataract Division, Brasília Ophthalmologic Hospital (HOB), Brasília-DF, Brazil; 2Renato Ambrosio Ophthalmologic Research Center (CEORA), 3Ophthalmology Department, São Paulo University – USP, São Paulo-SP, Brazil; 4Cataract Division, ProVisão, João Pessoa-PB, Brazil; 5Ophthalmology Department, Paulista Medical School – UNIFESP, São Paulo-SP, Brazil Purpose: To compare visual outcomes and performance between bilateral implantation of a diffractive trifocal intraocular lens (IOL) Acrysof®PanOptix® TFNT00 and blended implantation of two different near add power bifocal IOLs: Acrysof® Restor® SV25T0 in dominant eye and Acrysof® Restor® SN6AD1 in the nondominant eye.Methods: This prospective, nonrandomized, consecutive and comparative study assessed 20 patients (40 eyes) who had bilateral cataract surgery performed using the IOLs described. Patients were divided into groups, bilateral trifocal implant and blended implant. Evaluation included measurement of binocular uncorrected and corrected distance visual acuity at 4m (UDVA, CDVA) and uncorrected intermediate (60 cm) and near (at 40 cm) visual acuity; contrast sensitivity (CS) and visual defocus curve.Results: Postoperative CDVA comparison showed no statistical significance between groups. UDVA was significantly better in the trifocal groups. Under photopic conditions, the trifocal group had better CS in higher frequencies with and without glare. The binocular defocus curve demonstrated a trifocal behavior in both groups, with the bilateral trifocal group exhibiting better performance for intermediate vision.Conclusion: Both lens combinations were able to provide good near, intermediate and distance vision, with the trifocal group showing significantly better performance at intermediate distances and better CS under photopic conditions. Keywords: trifocal, blend, cataract surgery, IOL, multifocal, presbyopia

Wilson Takashi Hida,1–4 Patrick Frenzel Tzelikis,1–3 César Vilar,1,2 Mario Augusto Pereira Dias Chaves,1,2,5 Antônio Francisco Pimenta Motta,1–3 Pedro Carlos Carricondo,1–3 Bruna Vieira Ventura,1,2,4,6 Renato Ambrosio Junior,1–3 Walton Nosé,1,2,4 Milton Ruiz Alves1–3 1Department of Cataract of Brasília Ophthalmology Hospital (HOB), Brasília, Federal District, 2Renato Ambrosio Research Center (CEORA), Brasília, Federal District, 3Department of Ophthalmology of São Paulo University School of Medicine, (FM-USP), São Paulo, 4Department of Ophthalmology of São Paulo Federal University (UNIFESP) School of Medicine, São Paulo, 5ProVisão Hospital, João Pessoa, Paraíba, 6Pernanbuco Eye Hospital (HOPE), Recife, Pernambuco, Brazil Purpose: The purpose of this study was to compare intraoperative parameters between femtosecond laser-assisted cataract surgery (FLACS) and conventional phacoemulsification using Centurion® Vision System with Active Fluidics. Setting: This study was performed at Brasília Ophthalmologic Hospital, Brasília, Federal District, Brazil. Patients and methods: This was a prospective randomized comparative study. Patients with the diagnosis of cataract and surgical extraction programmed were divided into two groups: conventional phacoemulsification and FLACS. Intraoperative data were collected and submitted for statistical analysis. Results: A total of 400 eyes were enrolled, 200 in each group. There were no surgical complications. Groups were statistically equivalent in age and nucleus density. Cumulative dissipated energy and torsional time were significantly reduced in the FLACS group. Conventional surgery had less fluid usage, total case time and aspiration (ASP) time. Conclusion: FLACS with Active Fluidics System can reduce the ultrasound energy use during cataract surgery, in spite of increasing case time, fluid usage and ASP time. Keywords: FLACS, ultrasound, aspiration

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. Methods Patients were assigned randomly to three groups. Group 1 patients received a topical artificial tear substitute (placebo); group 2 received ketorolac tromethamine 0.4% (Acular LS, Allergan) and group 3 received nepafenac 0.1% (Nevanac, Alcon). The incidence and severity of CME were evaluated by retinal foveal thickness on optical coherence tomography (OCT) after 1, 4 and 12 weeks. Results One hundred and twenty-six eyes of 126 patients were included in this study. The between-group differences in visual outcomes, central corneal thickness and endothelial cell density were not statistically significant. In all retinal thickness measurements, an increase was detected starting from the postoperative first week until 12 weeks. There was no statistically significant difference between the three groups in any measurement performed by spectral-domain OCT. Conclusions Used prophylactically after uneventful cataract surgery, non-steroidal anti-inflammatory drugs were not efficacious in preventing macular oedema compared with placebo. Trial registration number ClinicalTrials: NCT02084576.

Objetivos: Comparar a performance visual dos pacientes submetidos ao implante das lentes intraoculares multifocais difrativas Tecnis® MF ZM900, Acrysof® Restor® SN60D3, Acrysof® SN60WF e Acrysof® SN60AT. Métodos: Estudo prospectivo comparativo, não randomizado, que incluiu 142 olhos de 71 pacientes com catarata, provenientes do ambulatório de oftalmologia do HC- FMUSP. A avaliação oftalmológica contou com medida da acuidade visual para longa, intermediária e curta distância, sem correção e com a melhor correção óptica, teste de sensibilidade ao contraste, pupilometria e análise de frente de onda por meio do aberrômetro. Um questionário de satisfação foi realizado para avaliar a acuidade visual, glare e halos. Todos os exames foram realizados com seis meses de pós-operatório. Resultados: A média de idade dos pacientes foi de 60,7 ± 6,6 anos no grupo Tecnis, 63,1 ± 4,4 anos no grupo Restor e 63,7 ± 4,2 anos no grupo monofocal (SN60AT no olho contralateral SN60WF). A acuidade visual para perto não corrigida e corrigida para longe foi estatisticamente superior nos grupos multifocal Restor e multifocal Tecnis em comparação ao grupo monofocal SN60AT/SN60WF (p

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 (p0,05). O grupo SN6AD1 obteve valor de 0,04 logMAR e o grupo ZMB00 de 0,09 logMAR para DCNVA (p

Purpose: To compare the efficiency of surgical procedures using three phaco tip designs in torsional phacoemulsification using the bevel-down technique. Methods: In this prospective, comparative, masked study, patients were randomly assigned to have torsional coaxial microincision cataract surgery using the mini-flared 45-degree Kelman tip, reversed mini-flared 30-degree Kelman tip, or Sidewinder 30-degree Kelman tip. Clinical measurements included preoperative and 3-month postoperative corrected distance visual acuity (CDVA), endothelial cell counts (ECC), and preoperative and 1-day postoperative central corneal thickness (CCT). Intraoperative measurements included phaco time, torsional time, aspiration time, case time, cumulative dissipated energy (CDE), and balanced salt solution volume (BSS). Results: The study evaluated 150 eyes of 150 patients. Intraoperatively, there was no statistically significant difference in cumulative dissipated energy, case time, torsional time, and aspiration time between the three tip configurations. However, less phaco time was used with the mini-flared 45-degree Kelman tip (p=0.02) than that with the Sidewinder 30-degree Kelman tip or reversed mini-flared 30-degree Kelman tip. The mini-flared 45-degree Kelman tip and the reversed mini-flared 30-degree Kelman tip required significantly less balanced salt solution volume than that required by the Sidewinder 30-degree Kelman tip (p=0.009). There was no statistically significant difference in corrected distance visual acuity and endothelial cell counts between tips 3 months postoperatively (p>0.05). Conclusion: All three tips were effective with no intraoperative complications. When using torsional phacoemulsification through microincisions and the prefracture technique with the bevel-down technique, the mini-flared 45-degree Kelman tip required a lower mean phaco time than the reversed mini-flared 30-degree Kelman tip and the Sidewinder 30-degree Kelman tip. Objetivo: Comparar a eficácia cirúrgica da facoemulsificação com tecnologia torcional utilizando 3 modelos diferentes de ponteiras. Métodos: Neste estudo prospectivo, randomizado, mascarado, os pacientes foram aleatoriamente distribuídos para serem submetidos a cirurgia de facoemulsificação coaxial torcional utilizando a ponteira Kelman mini-flared de 45 graus, ou Kelman reversed mini-flared de 30 graus ou Kelman Sidewinder de 30 graus. Os parâmetros avaliados incluíram: acuidade visual com correção (AVCC) para longe; contagem de células endoteliais (CCE) pré-operatória e pós-operatória, ao final de 3 meses; espessura corneana central (ECC) pré-operatória e no primeiro dia pós-operatório. Medidas intraoperatórias incluíram tempo de facoemulsificação, tempo de energia torcional, tempo da aspiração, tempo cirúrgico, energia dissipada acumulada (CDE) e volume de solução salina balanceada (BSS). Resultados: Este estudo avaliou 150 olhos de 150 pacientes. No intraoperatório, não foram observadas diferenças significativas na energia dissipada acumulada, tempo de facoemulsificação, tempo de energia torcional, e tempo de aspiração entre os 3 modelos de ponteira. No entanto, foi utilizando menos tempo de faco com a ponteira Kelman mini-flared de 45 graus (p=0,02) quando comparado às ponteiras Kelman Sidewinder de 30 graus e reversa mini-flared de 30 graus. A ponteira Kelman mini-flared de 45 graus e a reversa mini-flared de 30 graus utilizaram menos solução salina balanceada quando comparado à ponteira Sidewinder de 30 graus (p=0,009). Não foram observadas diferenças significativas na acuidade visual com correção, contagem de células endoteliais e espessura corneana central entre as diferentes ponteiras ao final do estudo (p=0,05). Conclusão: As 3 ponteiras foram eficazes e não apresentaram complicacões intraoperatórias. Quando foi utilizando o faco torcional através de microincisão com a técnica da pré-fratura, a ponteira Kelman mini-flared de 45 graus obteve um desempenho melhor que as ponteiras de 30 graus e Sidewinder de 30 graus, com menor tempo de faco.