Prevention and management of refractive prediction errors following cataract surgery

Abstract

Patient satisfaction after modern day cataract surgery requires excellent surgical technique but increasingly demands superior refractive outcomes as well. In many cases, there exists an expectation from patients, as well as surgeons, to achieve emmetropia after cataract surgery. This is particularly true in patients electing premium intraocular lens technology to correct astigmatism and presbyopia to minimize spectacle dependence. Despite continued advances in preoperative and intraoperative diagnostics, refractive planning, and surgical technology, residual refractive error remains a primary source of dissatisfaction after cataract surgery. The need to enhance refractive outcomes and treat residual astigmatic or spherical refractive errors postoperatively becomes paramount to meeting the expectations of patients in their surgical outcome. This article reviews the potential preoperative and intraoperative pitfalls that can be the source of refractive error, the various options to enhance refractive outcomes, and potential future technologies to limit residual refractive error after cataract surgery.

The Vivity Extended Range of Vision IOL vs the PanOptix Trifocal, ReStor 2.5 Active Focus and ReStor 3.0 Multifocal Lenses: A Comparison of Patient Satisfaction, Visual Disturbances, and Spectacle Independence

“…Older Americans more likely than in previous generations to be working and active, leading to increased visual demands and expectations of cataract surgery. 1 Internet and smart phone usage by Americans over age 65 has risen significantly in the past decade, 2 , 3 increasing the need for functional vision and spectacle independence at near, intermediate and distance post-cataract surgery. 4 , 5 …”

“…Older Americans more likely than in previous generations to be working and active, leading to increased visual demands and expectations of cataract surgery. 1…”

Current treatments for Meibomian Gland Dysfunction and Eye Lid Margin Disease

“…MGD and ELD are common presentations today in a comprehensive practice, refractive surgery, and refractive cataract surgery [37][38][39]. With increased screen time on computers and devices the authors have seen increasing dry eye disease.…”

Pseudophakic Presbyopic Corrections

“…When no measurements can be taken, A-scan ultrasound biometry can be used. However, since the accuracy of this method is lower than the accuracy of optical biometry, [86][87][88] and taking into account that even a residual refractive error of 0.50 D, especially in mIOL implantation, can reduce the vision quality and increase photic phenomena, [89][90][91] the surgeon should be cautious with the choice of the mIOL or even with the decision for a possible DOI: http://dx.doi.org/10.5772/intechopen.96528 non-mIOL pseudophakic presbyopic correction when an ultrasound biometry is used for the IOL power calculation. The surgeon should discuss with the patient the risks caused by the measurement inaccuracy, and may choose an alternative surgical solution according to patient's visual needs and lifestyle.…”