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George Aristotle Markakis, Nicholas Aristotle Apostolakis; Comparison of Anticipated Versus Actual Postoperative Refractive Errors for Akreos AO60 and Tecnis ZCB00 Intraocular Lenses in a Normal Cataract Population. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1304.
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© ARVO (1962-2015); The Authors (2016-present)
Cataract extraction is a very effective refractive surgery, which makes IOL predictability extremely important. The purpose of this study is to compare the predictability of refractive error after standard cataract surgery in a normal patient population for two IOLs: B&L Akreos AO60 and AMO Tecnis ZCB00.
Patients who underwent cataract surgery in 2014-2015 by the same surgeon, using the same techniques (standard, monofocal IOLs; distance vision correction; sutureless, temporally-oriented clear corneal incisions of 2.75mm for AO60, and 2.4mm for ZCB00) were randomly chosen from a database and screened for exclusion criteria (corneal, macular, or other ocular or cortical disease that could significantly impact final visual acuity). One eye (first to undergo surgery) of 10 patients was chosen for analysis for each type of IOL. Stable post-operative manifest refraction was then compared with anticipated post-operative refraction as calculated from optical power measurements (IOLMaster/Lenstar, SRK/T formula) that generate predicted spherical equivalent and residual corneal astigmatism. Differences between actual and predicted refractive error for patients in each IOL group were compared using two-tailed, paired Ttests, p < 0.05 significance.
Both IOL groups induced a mild myopic deviation from predicted values (AO60= -0.49+/-0.41D, p =0.004; ZCB00 = -0.46+/-0.40D, p=0.005). Whereas actual (0.68+/-0.66cyl) and anticipated (0.77+/-0.41cyl) postoperative astigmatisms did not differ for AO60 (p=0.46), ZCB00 did show a small but significant decrease (-0.35+/-0.24cyl, p=0.001) in actual postoperative astigmatism (0.48+/-0.61cyl) as compared to anticipated (0.82+/-0.59cyl). This decrease occurred for all patients regardless of axis. There were no significant differences in age, race, sex, eye, or preoperative refraction between patient populations of each IOL group.
Both AO60 and ZCB00 patients had an unexpected, mild myopic shift after cataract surgery. This could be a surgeon-specific systematic error. Whereas AO60 patients demonstrated no change from predicted astigmatism, ZCB00 patients experienced a reduction, regardless of axis, that could not be attributed to surgically induced astigmatism. ZCB00 could be used to treat patients with mild astigmatism who either do not need or cannot afford a toric IOL.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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