Eyeworld

14 | EYEWORLD | DECEMBER 2021 ASCRS/EYEWORLD JOURNAL CLUB ASCRS NEWS continued on page 16 During the ASCRS Journal Club discussion of this study, the panelists discussed the importance of "raising the bar" with regard to astigmatism management. assistance of a femtosecond laser. No formal treatment guideline was followed, but astigma- tism was typically managed with the following algorithm. Patients with between 0–0.75 D of astigmatism were managed by placing the clear corneal incision at the steepest meridian; patients with 0.75–1.50 D of astigmatism were typically corrected with femto laser astigmatic keratotomy. Patients with more than 1.50 D of astigmatism were considered for a toric intraoc- ular lens. The authors utilized multivariate regression to analyze the association of residual astigma- tism with both uncorrected distance visual acu- ity (UDVA) and patient satisfaction. They used correlation analysis to identity other potential contributing variables to be included in the multivariate analysis. Patients with multifocal IOLs and patients with monofocal IOLs were an- alyzed separately. The authors do not mention whether p-values were corrected for multiple comparators. Results In this cohort, the mean patient age was 58.99 years. A large majority (71.7%) of patients received a multifocal non-toric lens. Mono- focal non-toric (18.4%) was the second most common lens type, followed by multifocal toric (5.8%) and monofocal toric (4.1%). Among patients who received a multifocal lens (13,267 eyes), residual astigmatism of 0.25–0.50 D Review of "Effect of residual astigmatism on uncorrected visual acuity and patient satisfaction in pseudophakic patients" C ataract surgery is one of the most commonly performed surgeries in the U.S. and around the world. As such, researchers and innovators have provided an ever-increasing number of technological advancements such as new surgical instruments and intraocular lenses. In addition, large, retrospective database studies have allowed cataract surgeons to predict the outcomes of their procedures more accurate- ly. 1 However, some debate has remained in the literature regarding astigmatism management in postoperative pseudophakic patients. 2–4 Name- ly, there is no consensus on what amount of astigmatism is visually significant for patients after cataract surgery. 2–4 In this retrospective database study, Schallhorn et al. analyzed both visual acuity and subjective postoperative sur- vey results, stratified by the amount of residual astigmatism, to determine the effect of residual astigmatism on postoperative outcomes. Design and methods The authors utilized a retrospective database from Optical Express, a private practice in the U.K. All patients who underwent cataract or refractive lens exchange between July 2014 and June 2019 and attended their 3-month postoperative visit with full refraction were included. Patients with any prior ocular surgery were excluded from the study. Because a large percentage of patients targeted monovision or mini-monovision, only dominant eyes (target emmetropia) were enrolled in the study. The authors extracted demographic data, preoperative and postoperative corrected dis- tance visual acuity, uncorrected distance and near visual acuity, final refraction, intraocular lens data, and patient subjective postoperative questionnaire data. The question used from the postoperative survey was, "Thinking about your vision during the last week, how satisfied are you with your vision (without the use of spectacles or contact lenses)?" The response was scored on a 5-point scale with 1 being very satisfied and 5 being very dissatisfied. Surgeries were completed by 24 surgeons in 17 sites; all surgeries were completed with by Thomas Meirick, MD, and Parisa Taravati, MD Thomas Meirick, MD Ophthalmology Resident University of Washington Seattle, Washington Parisa Taravati, MD Residency Program Director Department of Ophthalmology University of Washington Seattle, Washington

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