A review of results after implantation of a secondary intraocular lens to correct residual refractive error after cataract surgery

Abstract

PurposeThe purpose of this study was to provide clinical outcomes data related to secondary intraocular lens (IOL) implantation for the correction of residual refractive error after cataract surgery.Patients and methodsA chart review was conducted to identify all eyes implanted with the monofocal spherical or toric AddOn® secondary IOL. Data were collated from charts where uncomplicated initial cataract surgery was completed. Measures of interest included the original IOL implanted, the postoperative refractive error (before secondary IOL implantation) and the associated corrected and uncorrected visual acuities (VAs). Postoperative data of interest included the residual refractive error, the best-corrected visual acuity (BCVA) and uncorrected visual acuity (UCVA).ResultsRefractive and VA data from 1 week to 3 months post-surgery were available for 46 of 70 eyes implanted with a secondary IOL by one surgeon at one practice between 4/15 and 3/17. There was a statistically significant improvement in UCVA of about 2 lines after surgery (p<0.01), with no change in BCVA (p=0.94). No eyes lost a line of BCVA. There was a statistically significant reduction in the absolute magnitude of the residual spherical equivalent refractive error (p<0.01). In the 10 cases with a toric secondary IOL, there was a statistically significant reduction in refractive cylinder (p<0.01).ConclusionThe secondary IOL studied here appears to be a viable surgical option to correct residual refractive error after primary IOL implantation.

<p>Spectacle Independence for Pseudophakic Patients – Experience with a Trifocal Supplementary Add-on Intraocular Lens</p>

“…Intraocular pressure remained practically unchanged in these studies. 11,15,24 Not even a transient increase in IOP was observed in this study; however, such changes have been reported in connection with the Sulcoflex Trifocal 703F supplementary IOL (Rayner Intraocular Lenses Ltd; Worthing, UK). 25 The convexconcave geometry, along with the four flexible loop haptics ensure enough space in the sulcus.…”

“…No complications were observed during surgery or in the postoperative period, which is a finding similar to previous studies involving the same ciliary sulcus lens family. 10,11,14,15,24 The design of the tested lenses supports the integrity and physiologic function of the anterior segment of the eye. Intraocular pressure remained practically unchanged in these studies.…”

“…10 Furthermore, manufacturers are making great efforts to design lenses that efficiently eliminate all complications that may arise from polypseudophakia or from the ciliary sulcus being the implantation site, such as iris chafing, pigment dispersion syndrome, pupillary block, angle-closure and secondary glaucoma. 7,[10][11][12][13] The aim of this study was to present the initial results obtained in connection with the implantation of the 1stQ AddOn ® diffractive supplementary IOL produced by Medicontur Medical Engineering Ltd (Zsámbék, Hungary) in pseudophakic patients who had previously had various monofocal capsular bag IOLs implanted. The patients in this study wished to become completely independent of spectacle correction.…”

“…Our choice of this supplementary add-on IOL family was justified by that, unlike similar lenses on the market, this platform has been reported to be safe in terms of stable positioning in various eyes, leaving an adequate interlenticular space between the lens and the primary IOL, and involving hardly any complications related to either the surgery or the postoperative course. 10,11,14,15 According to the manufacturer, the 1stQ AddOn diffractive supplementary IOL has an optic similar to the Medicontur Liberty ® 677MY capsular bag IOL, with clinical trifocal performance and spectacle independence of patients being confirmed in related studies. [16][17][18]…”

Evolution of IOL exchange. Part 2. Modern problems of IOL exchange

“…Кроме того, для коррекции рефракционных погрешностей после первой операции, помимо реимплантации ИОЛ или эксимерлазерных вмешательств на роговице, также используют имплантацию второй линзы по типу piggyback ИОЛ. При этом отмечается, что имплантация второй ИОЛ менее травматична по сравнению с заменой искусственного хрусталика [38][39][40][41][42]. Есть также предложение не выполнять сразу имплантацию piggyback ИОЛ при факоэмульсификации у больных с короткой переднезадней осью или у пациентов после кераторефракционной хирургии, а производить отсроченную имплантацию второй ирис-кло-линзы с ретропупиллярной фиксацией или ИОЛ с фиксацией в цилиарной борозде, что повышает точность окончательного рефракционного результата вмешательства, а также является менее травматичным вмешательством по сравнению с реимплантацией piggyback ИОЛ [43][44][45].…”