Impact of soft and rigid gas-permeable contact lenses on visual performance in mesopic conditions.

CONTEXT: Evaluation of visual quality in soft and rigid gas-permeable contact lens wearers, with an emphasis on twilight vision. PURPOSE: To assess the visual acuity and visual performance at dusk before and after soft and rigid gas-permeable contact lens (CL) correction in healthy subjects. SETTINGS AND DESIGN: This prospective study was conducted in a tertiary eye-care center. METHODS: Sixty eyes corrected with soft contact lenses (SCLs) and 30 eyes with rigid gas-permeable contact lenses (RGPCLs) were enrolled in this study. Patients underwent corrected distance visual acuity with spectacles (CDVAs), corrected distance visual acuity with contact lenses (CDVAcl), and twilight vision (TV) testing (Vista Vision Far-Pola, DMD MedTech charts). Parameters were evaluated before and after the CL fitting and repeated 3 months after the baseline visit. STATISTICAL ANALYSIS USED: MedCalc for Windows, version 11.4 (MedCalc Software, Ostend, Belgium). RESULTS: Rigid gas-permeable CL wear showed significant improvement in CDVAcl compared to wearing spectacles on both visits ( P = 0.0039 and P = 0.0003, respectively). TV with CLs was significantly better in both groups compared to the TV with spectacles at the baseline visit ( P = 0.0011 in SCL group; P = 0.0001 in RGPCL group), and at the follow-up visit, this significance was proven for the RGPCL group ( P = 0.001). Also, spectacle TV showed a significant improvement on the follow-up visit ( P = 0.0022 in SCL group; P = 0.0269 in RGPCL group). CONCLUSION: Contact lens wear improves visual performance compared to spectacles. TV results showed superiority of CLs compared to the spectacles, without a statistical difference regarding the CL type.

Immediate Sequential Bilateral Cataract Surgery in Patients with Bilateral Visually Significant Cataracts.

Purpose: To report our experience of performing immediate sequential bilateral cataract surgery (ISBCS) in patients with visually significant cataracts and reduced preoperative corrected distance visual acuity (CDVA). Methods: Data of patients who underwent ISBCS for visually significant cataracts and had preoperative CDVA ≤20/32 (≤0.2 logMAR) in each eye were retrospectively reviewed. Refractive and visual outcomes were evaluated for the last available postoperative visit. Intraoperative and serious postoperative adverse events occurring within the first three months of surgery were reviewed. Results: A total of 1335 patients (2670 eyes) were included in the analysis, with a mean age of 71.9 ± 9.5 years. On the last visit, 50.2% and 89.1% of eyes achieved uncorrected distance visual acuity (UDVA) ≥20/20 (0.0 logMAR) and ≥20/32 (0.2 logMAR), respectively. Of all eyes, 83.8% were within ±0.50D, and 96.4% were within ±1.00 D of emmetropia. Ten patients had postoperative bilateral ametropia of more than 1.00D in each eye, but eight of them still achieved binocular UDVA ≥20/40. Intraoperative events occurred in 14 eyes of 13 patients (per-eye incidence: 0.524% or 1 in 191 eyes). A total of 86 postoperative adverse events occurred in 80 eyes of 53 patients (per-eye incidence 2.996% or 1 in 33 eyes), of which cystoid macular edema was the most common. Only three eyes had CDVA reduced by more than two Snellen lines compared to preoperative CDVA, two of which were not related to cataract surgery. There was no patient with bilateral CDVA loss. Conclusion: In our cohort of patients with visually significant cataracts, ISBCS resulted in good refractive predictability and a low incidence of serious adverse events.