Target refraction for best uncorrected distance and near vision in cataract surgery

To assess the target refractive error after cataract surgery to achieve best uncorrected visual acuity for both distance vision and reading vision.

The study included patients consecutively undergoing routine phacoemulsification with clear corneal incisions and implantation of a foldable monofocal intraocular lens (IOL). Uncorrected distance visual acuity (UCDVA), best-corrected distance visual acuity (BCDVA), uncorrected near visual acuity (UCNVA,) and best-corrected near visual acuity were measured at 93 ± 47 days (minimum 4 weeks) after surgery. Inclusion criteria were a postoperative cylindrical refractive error ≤1.5 D and an unremarkable postoperative status.

The study included 493 eyes of 493 patients with a mean age of 74.2 ± 8.7 years and mean axial length 23.4 ± 1.1 mm. The UCDVA significantly (p<0.001) increased with decreasing myopic refractive error (spherical equivalent) towards emmetropia and then significantly (p<0.001) decreased with increasing hyperopic refractive error. The UCNVA significantly (p<0.001) decreased with decreasing myopic and increasing hyperopic refractive error. The ascending UCDVA line and the descending UCNVA line intersected in the refractive error range (spherical equivalent) of -1.00 D to -1.50 D. For patients with a BCDVA of ≥20/25, the lines of UCDVA and UCNVA intersected at a UCDVA range between 20/40 (logMAR 0.30; -1.5 D) and 20/32 (logMAR 0.26; -1.0 D) and at a UCNVA range between Jaeger 3 (logMAR 0.26) and Jaeger 4 (logMAR 0.32).

For routine unilateral cataract surgery with implantation of monofocal IOLs, target refractive error to achieve best uncorrected distance and near vision was in the range of -1.00 D to -1.50 D (spherical equivalent).