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


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

Methods: 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.

Results: 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).

Conclusions: 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).

Eur J Ophthalmol 2014; 24(4): 509 - 515


Article Subject: Lens/Cataract



Alexander K. Schuster, Frank C. Schlichtenbrede, Björn C. Harder, Sven C. Beutelspacher, Jost B. Jonas

Article History


Financial Support: No financial support was received for this submission.
Conflict of Interest Statement: None of the authors has conflict of interest with this submission.

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  • Department of Ophthalmology, Medical Faculty Mannheim, Ruprecht-Karls-University Heidelberg - Germany

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