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    Effects of astigmatism greater on multifocals than monofocals IOLs

    How various magnitudes and manifestations impact optical quality, patient satisfaction



    The effect of astigmatism varies with different factors and can affect patient satisfaction with multifocal or monofocal IOLs.


    Dr. MacRae

    Rochester, NY—The effect of astigmatism varies with different factors, such as magnitude, manifestation, light level, and dominant or non-dominant eye.

    “These factors all affect the patient satisfaction with multifocal or monofocal IOLs,” said Scott M. MacRae, MD, professor of ophthalmology, and professor of visual science, University of Rochester, Rochester, NY.

    How pupil size plays role

    The use of multifocal and accommodating IOLs raised a number of questions for Dr. MacRae and colleagues, Len Zheleznyak, MS, and Geunyoung Yoon, PhD. They began studying the effect of astigmatism and higher-order aberrations on visual performance and found that the size of the pupil has a great impact on astigmatic magnitudes.

    For example, when going from a 2- to 6-mm pupil, the amount of the reduction in image quality resulting from the astigmatism is about 50% as the pupil dilates, Dr. MacRae explained.

    “This becomes even more profound with higher degrees of astigmatism, that is, from over 0.75 to 1.5 D. This may be mildly or very disabling for a patient who is not corrected for the astigmatic effect,” he said.

    These patients can function while driving in bright light, for example, but not at night in dim light, he noted.

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