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To report the refractive outcomes of cataract surgery with implantation of advanced technology presbyopia-correcting IOLs (ATIOLS), including combination presbyopia-astigmatism correcting ATIOLs, performed by resident surgeons in training.
Retrospective chart review of 98 cataract surgeries staffed by the same attending surgeon with implantation of ATIOLs performed by 8 different resident physicians over 3 years. A variety of currently available ATIOLs were implanted, including accommodating, apodized and non-apodized diffractive multifocal, and extended depth-of-focus lenses (as well as toric varieties). All visits prior to and after cataract surgery recorded uncorrected distance (UDVA), intermediate (UIVA), and near visual acuity (UNVA), along with pre-op and post-op keratometric and refractive astigmatism. Post-op UDVA, UIVA, and UNVA were used for either the 1, 3, or 6-month post-op time points based on patient follow-up.
For patients receiving non-apodized diffractive and apodized diffractive multifocal ATIOLs, 72% had UDVA of 20/25 or better, 100% had UDVA of 20/40 or better, and 98% had either UNVA or UIVA of 20/30 or better. For patients receiving extended depth of focus lenses, 65% had UDVA of 20/25 or better, 96% had UDVA of 20/40 or better, and 89% had either UNVA or UIVA of 20/30 or better. For patients receiving accommodating lenses, 74% had UDVA of 20/40 or better, and 100% had either UNVA or UIVA of 20/30 or better. For toric lenses, there was a mean pre-op cylinder of 1.83 +/- 0.17 diopters and a mean post-op cylinder of 0.55 +/- 0.09 diopters (p<0.01).
Surgical educators may be hesitant to introduce ATIOLs to trainees. Our study demonstrates that novice surgeons can have excellent surgical results when performing ATIOL cataract surgery with appropriate supervision. With increasing popularity of ATIOLs, educators may wish to incorporate the full spectrum of available ATIOLs in their curricula.