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    Effects of astigmatism greater on multifocals than monofocals IOLs

    How various magnitudes and manifestations impact optical quality, patient satisfaction

     

    Dominant versus non-dominant eye

    The effects of the astigmatism are greater in the dominant eye than the non-dominant eye, Dr. MacRae noted.

    “In the non-dominant eye, for near vision tasks, patients are not affected by myopic against-the-rule astigmatism,” he said.

    Correction of the astigmatism in the dominant eye will result in good binocular function at distance.

    The investigators found that with increasing astigmatism, the image quality decreases— especially in multifocal wearers compared with monofocal and pseudoaccommodating IOL users.

    “This finding indicates that we need to be more attuned to subtle levels of astigmatism for multifocal patients,” he said.

    “Less than 0.5 D of astigmatism has a negligible effect on visual acuity and visual performance, while 0.75 D definitely affects the image quality,” Dr. MacRae said. “The visual system is tuned to horizontal and vertical directions; there is worse visual performance with oblique astigmatism and better visual performance with horizontal and vertical astigmatism.

    “Astigmatism has greater effect on multifocals than monofocals IOLs, resulting in reduced depth of field and image quality,” he said. “Finally, astigmatism reduces the image quality more with larger pupils, with multifocal IOLs [being] particularly susceptible.”

     

    Scott M. MacRae, MD

    E: Scott_Macrae@urmc.rochester.edu

    Dr. MacRae is a consultant to AcuFocus, Bausch + Lomb, and Ziemer.

     

     

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