97th DOG Annual Meeting 1999
REFRACTIVE OUTCOME, ANTERIOR CHAMBER DEPTH, DECENTRATION AND TILT
AFTER MONOFOCAL AND MULTIFOCAL SILICONE INTRAOCULAR LENS IMPLANATION
B. Dick, O. Schwenn, N. Pfeiffer
The purpose of this prospective study was to investigate changes in re-frac--tion, anterior chamber depth, decentration and tilt after implan-ta-tion of multifocal (MIOL) and monofocal (MONO) intra-ocular lenses (IOL).
Patients and Methods: A total of 90 cataractous eyes from 90 patients, who were scheduled to undergo phaco-emulsification with IOL implant sur---gery, were included. Either a three-piece monofocal (SI-40NB, Aller-gan; n=51) or multifocal silicone IOL (SA-40N, Allergan; n=31) was im-planted in the capsular bag after circular capsulorhexis. Anterior cham-ber depth (ACD), length of IOL decentration and degree of IOL tilt were quanti-fied using a Scheim-pflug camera. Examina-tions were per-formed pre---opera-tively, at 1 week as well as 6 months post-operatively. More-over, sub--jec-tive refrac-tion was determined.
Results: 93.3 % of the eyes with a MIOL were within a range of ±1 dpt (spherical equivalent) from the target refraction, all eyes were within ±2 dpt. No significant refractive shift or ACD change occured during the post---operative course. In the MIOL group, post-opera-tive ACD (median) was 4.90 mm and 4.78 mm at 3 days and 6 months, respec-tively. In the MONO group, postoperative ACD was simi-lar: 4.96 mm and 4.88 mm at 3 days and 6 months, re-spective-ly. Intra-individual ACD demonstrated no statistically signi-ficant change during the post-operative course. After 6 months, no clinically rele-vant decen-tration (mm) could be observed in the MIOL group (median: 0; range: 0 to 0.58) as well as in the MONO group (median: 0.14; range: 0 to 0.9). 6 months post-opera-tively, tilt (de-gree) valued 1.0 (median; range: 0 to 2.6) in the MIOL group and 1.0 (median; range: 0 to 2.5) in the MONO group. There was no statisti-cally signi-fi-cant change in intraindividual IOL de-cen--tra-tion or tilt.
Conclusion: Three-piece monofocal and multifocal silicone IOLs with rigid PMMA haptics implanted in the capsular bag after circular cap-su-lo--rhexis pro-vide a good centration and very little tilt without signi-fi-cant change up to six months after surgery. A statistically significant re-frac-tive shift did not occur within 6 months post-opera-tively.
Department of Ophthalmology, Johannes Gutenberg-University,
Langen-beckstr. 1, 55131 Mainz