Original Article
Violette Vrijman, MD; Jan Willem van der Linden, BOpt; Carla P. Nieuwendaal, MD; Ivanka J.E. van der Meulen, MD; Maarten P. Mourits, MD, PhD; Ruth Lapid-Gortzak, MD, PhD
- Journal of Refractive Surgery
- August 2012 - Volume 28 · Issue 8: 545-550
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DOI: 10.3928/1081597X-20120723-03
Abstract
PURPOSE:
To evaluate the effect on refraction of neodymium:YAG (Nd:YAG) laser posterior capsulotomy for posterior capsule opacification (PCO), and to evaluate the correlation between automated and subjective refraction in multifocal apodized diffractive pseudophakia.
METHODS:
A retrospective study of 75 pseudophakic eyes (50 patients) with multifocal apodized diffractive pseudophakia, treated for PCO with Nd:YAG laser posterior capsulotomy, was performed. Pre- and postintervention values of refractive and visual parameters were compared. The outcomes of autorefraction and subjective refraction were also compared.
RESULTS:
Uncorrected and corrected distance visual acuity improved significantly after Nd:YAG capsulotomy (P<.001). No significant changes were noted in defocus equivalent, astigmatic power vectors J0 and J45, and overall blurring strength in subjective refraction and autorefraction. Spherical equivalent changed significantly in autorefraction (P=.008), but not in subjective refraction. Autorefraction and subjective refraction were highly correlated in spherical equivalent, defocus equivalent, and blurring strength (r2>0.59). In approximately 7% of eyes, a change of more than 0.50 diopters in spherical equivalent in subjective refraction occurred.
CONCLUSIONS:
In most cases, Nd:YAG laser capsulotomy in patients with multifocal pseudophakia did not result in a change in refraction. However, 7% of eyes experienced a significant change in subjective refraction. Autorefraction correlated well with subjective refraction in apodized diffractive multifocal IOLs.
From the Department of Ophthalmology, Academic Medical Center, University of Amsterdam (Vrijman, Nieuwendaal, van der Meulen, Mourits, Lapid-Gortzak); and Retina Total Eye Care, Driebergen (van der Linden, van der Meulen, Lapid-Gortzak), The Netherlands.
Dr Lapid-Gortzak received speaker fees from Alcon Inc, Hanita Lenses Ltd, and Oculentis GmbH. Drs van der Meulen and Lapid-Gortzak received an unrestricted research grant from Oculentis GmbH and Hanita Lenses Ltd. The remaining authors have no financial or proprietary interest in the materials presented herein.
AUTHOR CONTRIBUTIONS
Study concept and design (J.W.vdL., C.P.N., I.J.E.vdM., M.P.M., R.L.G.); data collection (V.V., J.W.vdL.); analysis and interpretation of data (V.V., J.W.vdL., R.L.G.); drafting of the manuscript (V.V., J.W.vdL.); critical revision of the manuscript (C.P.N., I.J.E.vdM., M.P.M., R.L.G.); statistical expertise (V.V.); supervision (M.P.M., R.L.G.)
Correspondence: Ruth Lapid-Gortzak, MD, PhD, Dept of Ophthalmology, Academic Medical Center, Meibergdreef 9, 1100 AZ Amsterdam, The Netherlands. Tel: 31 20 5663811; E-mail: r.lapid@amc.nl
Received: February 26, 2012
Accepted: June 20, 2012
doi: 10.3928/1081597X-20120723-03