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

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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.

PURPOSE: To compare the distribution of ocular higher order wavefront aberrations (third to sixth order) in the Brazilian population of Asian and non-Asian refractive surgery patients. METHODS: Preoperative refractive and wavefront data were reviewed for 648 eyes in 324 patients who underwent custom ablation at the Excimer Laser Santa Cruz refractive surgery center in São Paulo, Brazil, from March 2002 to July 2005. Patients were divided into two groups: Asian patients and non-Asian patients, based on family history. Statistical analysis was performed to assess the differences between the groups with respect to manifest refractive spherical equivalent, astigmatism, pachymetry, OPD-root-square-mean (RMS) for a 6.0-mm pupil, total wavefront aberrations, third- to sixth-order higher order aberrations, and individual aberrations. RESULTS: The mean spherical equivalent refraction in the Asian group of -4.38 diopters (D) was significantly higher than the spherical equivalent refraction of -3.46 D in the non-Asian group (t=-4.32; P=.00001). Comparison of the differences between groups with respect to higher order aberrations, coma, trefoil, quadrafoil, spherical aberration, higher order astigmatism, and pachymetry was not statistically significant. CONCLUSIONS: Asian patients have a higher prevalence of myopia than non-Asian patients. No differences were noted in higher order aberrations between Asian and non-Asian patients. [J Refract Surg. 2006;22:S1024-S1026.]

Purpose: Development and validation of quality of life questionnaire in pseudophakic patients in Portuguese. Methods: The modified Cataract TyPESpecification questionnaire was specifically developed to assess quality of life after cataract surgery, functional status evaluated with 10 items and contains 18 questions. All questions were applied by a single examiner, with the goal of graduating visual satisfaction from 0 to 10 (0 means very dissatisfied, 5 neutral, 10 very satisfied).This prospective comparative study included 142 eyes of 71 patients in Sao Paulo University. The ophthalmologic evaluation performed included near, intermediate and distance corrected and uncorrected visual acuity and quality of life questionaire. The minimum follow-up was 6 months. Results: The mean age of patients was 60.7± 6.6 years in theTecnis ® MF, 63.1 ±4.4 years in-groupRestor ® 63.7±4.2 years in-group SN60AT/SN60WF. Uncorrected and distance-corrected near visual acuity were statistically higher in theRestor ® and Tecnis ® groups compared to the SN60AT/SN60WF group (p<0.001). There were no statistical differences between groups comparing uncorrected and best-corrected distance visual acuity (p=0.56). Satisfaction questionnaire showed high glasses independence fortheTecnis ® MF (9.3 /10) and Restor ® (8.7 /10) INTRODUCTIONP hacoemulsification and IOL implantation using increasingly smaller incisions have allowed rapid visual recovery with low rates of complications in the hands of experienced surgeons, as well as good quality of vision in the postoperative period. Assessment of the quality of vision can be done through various tests, such as those assessing contrast sensitivity, which is the ability to distinguish the details of images and depends on ambient brightness (1)(2)(3)(4) .In order to provide additional benefits to the visual quality of pseudophakic patients, intraocular lenses (IOLs) have been refined using an aspherical lens design to correct positive spherical aberrations of the cornea (5)(6)(7)(8) . One such aspherical lens is the SN60WF lens, developed from the SN60AT lens, both produced by Alcon Laboratories (Fort Worth, Texas, USA). The former provides greater reduction in spherical aberrations with better vision in low light conditions and increased contrast sensitivity in the postoperative period compared to the latter (5,6,9) .Monofocal IOLs are traditionally used for intraocular implants in cataract surgery. Do to their lack of optical correction, they do not provide a satisfactory depth of focus at varying distances. Despite the potential benefits of multifocal IOLs, their indications are still limited (10,11) .More advanced multifocal IOLs aim to provide contrast sensitivity similar that accepted for monofocal IOLs and to induce minimal optical aberrations. However, the scientific literature reports a loss of contrast sensitivity and functional vision associated with photic phenomena that affect patient satisfaction (12,13) .The aim of this study was to develop and evaluate a quality of life qu...

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