Benefit of against-the-rule astigmatism to uncorrected near acuity

Trindade, Fernando Cançado; Oliveira, A. G. F.; Frasson, Maria

doi:10.1016/s0886-3350(97)80155-1

Cited by 79 publications

(76 citation statements)

References 3 publications

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“…We also confirmed the intensified presence of corneal aberrations at an elderly age. It is well known that mild ATR myopic astigmatism can be beneficial to uncorrected near acuity in pseudophakic eyes, 34 although in our smaller cohort of patients, no correlation was found between the subjective accommodation amplitude and the direction of astigmatism.…”

Section: Discussioncontrasting

confidence: 73%

Accommodation in phakic and pseudophakic eyes measured with subjective and objective methods

Németh

Lipécz

Szalai

et al. 2013

Journal of Cataract and Refractive Surgery

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PURPOSE:To measure accommodation subjectively and objectively and assess anterior segment changes during accommodation in phakic eyes and pseudophakic eyes. METHODS: Subjective and objective accommodation measurements and pupillometry were performed in phakic and pseudophakic patients. Refraction and pupil diameter were recorded with different accommodation stimuli. Corneal higher-order aberrations (HOAs) and anterior chamber depths (ACDs) were detected with a rotating Scheimpflug camera. RESULTS:The mean age of the 44 patients in the phakic group was 36.34 years G 16.6 (SD) and of the 27 patients in the pseudophakic group, 69.3 G 9.98 years. The mean subjective accommodation was 4.49 G 3.48 diopters (D) in phakic eyes and showed significant correlation with age, spherical aberration, changes in pupil diameter, and ACD. The mean subjective accommodation was 0.50 G 0.28 D in pseudophakic eyes. In phakic eyes, the mean objective accommodation was 0.46 G 1.02 D, 1.06 G 1.33 D, and 2.2 G 1.9 D with 2.0 D, 3.0 D, and 5.0 D, respectively, of stimulus. In pseudophakic eyes, measurable objective accommodation was recorded. In phakic eyes, the correlations were significant between these values and age, changes in ACD, pupil size, and corneal spherical aberration. In pseudophakic eyes, the only correlation was with the spherical equivalent value.

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Section: Discussioncontrasting

confidence: 73%

Accommodation in phakic and pseudophakic eyes measured with subjective and objective methods

Németh

Lipécz

Szalai

et al. 2013

Journal of Cataract and Refractive Surgery

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“…Traditionally it has been perceived that residual myopic against the rule cylinder may improve uncorrected near vision. 5 In a study conducted recently at our centre, it was seen that myopic astigmatism, up to 1D, in any axis, helps to partially restore uncorrected near visual acuity to some extent but with a proportional loss of distance acuity in pseudophakic eyes with monofocal IOL implant. However, uncorrected myopic astigmatism more than 1 D results in a large loss of distance acuity at no additional benefi t to near acuity.…”

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confidence: 97%

Management of Astigmatism in Cataract

Taneja¹

2015

DJO

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With the recent advances in the instrumentation and intraocular lens (IOL) technology, cataract surgery has, over the past few years, become quite akin to refractive surgery allowing greater control over the patients' refractive and visual outcome. Now the patients expect perfect vision after cataract surgery and surgeons strive hard to deliver the same. In this respect residual astigmatism after cataract surgery is viewed as an undesirable outcome both by the patients and surgeons.In a general cataract population, approximately 10% of patients have astigmatism with greater than 2 D of cylinder, 20% have between 1 and 2 D, and 70% have less than 1 D.1-4 Therefore one may consider treating pre-existing astigmatism in about one out of every three patients. The aim would be to leave the patient with a refractive outcome, for both sphere and cylinder, of 0.50 D or less.However, some surgeons advocate a litt le less aggressive approach to the reduction of residual cylinder as a litt le astigmatism could, in fact, improve uncorrected near vision. Traditionally it has been perceived that residual myopic against the rule cylinder may improve uncorrected near vision. 5In a study conducted recently at our centre, it was seen that myopic astigmatism, up to 1D, in any axis, helps to partially restore uncorrected near visual acuity to some extent but with a proportional loss of distance acuity in pseudophakic eyes with monofocal IOL implant. However, uncorrected myopic astigmatism more than 1 D results in a large loss of distance acuity at no additional benefi t to near acuity. Also, uncorrected hyperopic astigmatism, in any axis, results in deterioration of both distance and near acuities of pseudophakic eyes.6 So a myopic astigmatism less than 1.0 D may be considered benefi cial for near vision by some surgeons, but of doubtful value beyond that.Various

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“…So it depends on patient cooperation and understanding. Subjective methods were found to be more reliable for measuring apparent accommodation according to Langenbucher et al 16 Many previous researches confirmed that the amplitude of apparent accommodation is correlated with different factors including; depth of focus 17,18 , pupil diameter 4,19 , degree of corneal astigmatism 20 , corneal multifocality and aberrations 21,22 , and IOL axial forward movement. 23,24 Depth of focus is an intrinsic characteristic of all optical systems that was considered to be one of the most significant factors of apparent accommodation.…”

Section: Discussionmentioning

confidence: 99%

The Analysis of Refraction and Accommodation of Extreme Myopia with Cataract after Phacoemulsification and IOL Implantation

Al-Wesabi¹,

Yang²,

Li³

et al. 2016

IOSR

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Abstract:Background: To assess the refractive status of cataract patients with extreme myopia and to measure their accommodative capability after monofocal IOL implantation. Design: Prospective non-randomized study conducted at Tianjin Medical University Eye Centre.Participants: 18 patients with 34 extreme myopic eyes ≥27mm axial length), and 14 patients with 27 non-myopic eyes that had uneventful phacoemulsification and monofocal IOL implantation. Methods:The accommodation amplitude of the two groups was compared pre-and post-operatively using subjective minus-lenses-to-blur method. In the extreme myopic group, the postoperative target refraction was selected to be myopic, and they were evaluated for predicted postoperative spherical power consistency.

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Benefit of against-the-rule astigmatism to uncorrected near acuity

Abstract: In pseudophakia, low, simple, ATR myopic astigmatism is better than WTR astigmatism because it provides superior uncorrected near visual acuity.

Cited by 79 publications

References 3 publications

Accommodation in phakic and pseudophakic eyes measured with subjective and objective methods

Accommodation in phakic and pseudophakic eyes measured with subjective and objective methods

Management of Astigmatism in Cataract

The Analysis of Refraction and Accommodation of Extreme Myopia with Cataract after Phacoemulsification and IOL Implantation

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