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Refractive aspects of cataract surgery.

I H Fine¹, R S Hoffman

¹Oregon Eye Associates, Eugene 97401, USA.

Current Opinion in Ophthalmology

|January 8, 1996

Summary

Cataract surgery now focuses on precise refractive outcomes. Advanced techniques and multifocal lenses aim to correct vision and restore accommodation for emmetropia.

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Area of Science:

Ophthalmology
Refractive Surgery
Biomedical Engineering

Background:

The primary goal of cataract surgery has evolved from merely restoring vision to achieving emmetropia (perfect vision).
Surgically induced astigmatism and pre-existing astigmatism have been significant challenges in achieving optimal refractive outcomes.
The loss of accommodation in the pseudophakic state necessitates solutions beyond simple refractive correction.

Purpose of the Study:

To highlight the shift in cataract surgery towards perfecting refractive outcomes.
To discuss advancements in lens power calculations and astigmatism correction techniques.
To explore the potential of multifocal lenses and corneas in addressing myopia, hyperopia, and accommodation loss.

Main Methods:

Review of current trends in cataract surgery.
Analysis of advancements in intraocular lens (IOL) power calculation formulas.
Evaluation of surgical techniques for astigmatism management (e.g., toric IOLs, limbal relaxing incisions).
Assessment of multifocal IOL technology and novel corneal procedures.

Main Results:

Improved accuracy in lens power calculations leads to better refractive predictability.
Refined surgical techniques effectively reduce or eliminate surgically induced and pre-existing astigmatism.
Multifocal lens technology and multifocal corneas show promise in correcting refractive errors and potentially restoring some accommodative function.

Conclusions:

The current emphasis on refractive outcomes in cataract surgery is driving innovation in surgical techniques and IOLs.
Achieving emmetropia is increasingly attainable through precise calculations and astigmatism management.
Multifocal solutions offer a pathway to address not only refractive errors but also the functional deficit of accommodation.

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