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E. Vingolo, E. Pacella, D. Domanico, S. Lupo, L. Scorolli, C. Balacco Gabrieli; Prolate anterior surface IOLs (PASIOLs), effects on visual function . Invest. Ophthalmol. Vis. Sci. 2004;45(13):320.
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Purpose: New surgical techniques and foldable IOLs move post operative goal is not only the improvement of visual acuity but reaching the best quality of vision. Refractive abberrations may provocate limitation of theoretical visual acuity, this value is the result of several single aberration due to each ocular optical interface. Use of PASIOLs cause a reduction of ocular aberrations, Visual Acuity, Contrast sensitivity and visual field showed better clinical performance than Acrylic IOL (AcIOL). Our goal was to assess if better images on the retina mean better retinal sensitivity. Materials: 15 patients aged between 50–70 yrs without other ocular pathologies operated in both eyes randomically selected by two surgeons, in one eye was implanted acrylic IOL in the other the PASIOL. We performed 3,4mm incision Anterior Capsulorexis <6mm, aspirating all cortical and viscoelastic material, with care to the anterior capsule rim. in both eyes were done BCVA, aberrometry, MP1 Nidek microperimetry with central threshold strategy 10–2 program evaluating single point retinal sensitivity (SPRS) considering a deviation of at least 2 dB as significant, mean sensitivity and fixation stability testing after a demo program, RE tested first. Results: comparing SPRS in our study group 15,2% of points showed better sensitivity for AcIOLs, 39,5% of tested points were equal and 46,3% showed a better performance in PASIOL. Moreover BCVA and Mean sensitivity were higher in the PASIOL group even with low significance value trend (p=0,58). Discussion: our results describe the retinal effects due to a PASIOLs determinating increase of retinal sensitivity with no change in BCVA, confirming other reports showing central retinal sensitivity evaluated whit 30–2 program. Microperimetric data are more reliable than others psychophysical because originated by the retinal stimulation because retinal location and the optic pathway of the stimulus are very precise so that may be affected by the presence of ocular aberration much more than outsurces clinical examinations as standard computerized perimetry or contrast sensitivity. Use of PASIOL is not only targeted to increase visual acuity but to the reaching of optimal vision and a better quality of sight. Thus because today cataract surgery involves younger subjects and due to a longer duration of life with better functional requests like driving, working with computer or other visual devices in such way restoring a better quality of vision may be the meaning of a more complete recovery of daily life relationships
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