Diffractive optic intraocular lens exchange: indications and outcomes

Alsetri, Hasan; Pham, Don; Masket, Samuel; Fram, Nicole R.; Naids, Steven; Lee, Aron

doi:10.1097/j.jcrs.0000000000000815

Cited by 9 publications

(7 citation statements)

References 18 publications

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“…These results are congruent with our prior experience with sulcus placement of IOLs with ISF as a strategy for managing various types of dysphotopsias. [21][22][23][24] This study is generally consistent with previous reports regarding complications and benefits of ISF for cases where capsule bag fixation of the IOL is not possible or desirable. 10,15,18,25 This finding is both interesting and somewhat surprising in that the current series includes only those cases that had a well-defined posterior chamber, given that the inclusion criteria included the presence of at least 270 degrees of an intact and stable capsule bag remnant.…”

Section: Discussionsupporting

confidence: 90%

Surgical outcomes of intraocular lens iris suture fixation in eyes with residual capsule support

Alsetri,

Masket,

Fram

et al. 2024

J Cataract Refract Surg

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Purpose: To evaluate the safety and refractive outcomes of eyes following IOL iris suture fixation (ISF). Setting: Private Practice, Los Angeles, CA. Design: Non-randomized and unmasked retrospective chart review Methods: We included eyes that underwent IOL exchange or repositioning with ISF with at least 270 degrees of capsular support. We excluded eyes with less than 270 degrees of capsular support, and eyes with iris damage. The primary outcome measures included incidence of cystoid macular edema (CME), IOL dislocation requiring refixation, and chronic inflammation. Secondary outcome measures included worsening IOP control, retinal tear or detachment, worsening of CDVA, and corneal decompensation. Refractive outcomes for 26 subgrouped eyes included mean and median spherical equivalent refraction accuracy (SERA), and % eyes within 0.5D and 1D of the refractive target. Results: The study included 53 eyes of 50 patients. CME: 2/53 (3.8%), IOL dislocation requiring refixation: 2/53 (3.8%), chronic inflammation: 1/53 (1.9%), worsening IOP control: 5/53 (9.4%), retinal tear or detachment: 2/53 (3.8%). No patient experienced worsening of CDVA from baseline or corneal decompensation. Mean SERA ± standard deviation: -0.35 ± 0.29D, median SERA: -0.37D. Of the 26 eyes subgrouped for refractive analysis, 73% were within 0.5D and 100% were within 1D of the desired refractive outcome. Conclusions: ISF can offer stability for sulcus fixated IOLs provided there is some residual capsule support. Although there are measurable complications, there is a relatively low side effect profile. The refractive error tended to be myopic, indicating the need for further refinement of IOL power predictive formulae.

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Section: Discussionsupporting

confidence: 90%

Surgical outcomes of intraocular lens iris suture fixation in eyes with residual capsule support

Alsetri,

Masket,

Fram

et al. 2024

J Cataract Refract Surg

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“…Some IOLs have characteristic—spider web patterns around point sources of light, reduced quality (waxiness) of vision, and nighttime driving difficulty. 6…”

Section: Methodsmentioning

confidence: 99%

“…Some IOLs have characteristic-spider web patterns around point sources of light, reduced quality (waxiness) of vision, and nighttime driving difficulty. 6 Opaque IOL Loss of clarity of the optic due to calcific degeneration, glistenings, or subsurface nanoglistenings.…”

Section: Indications For Surgerymentioning

confidence: 99%

“…In a recent publication, we reported our outcomes for IOL exchange in 64 eyes with diffractive optic dysphotopsia (DOD). 6 In that series, approximately 20% of cases did not have capsule bag–to–capsule bag exchange owing to prior capsulotomy or other conditions. Nevertheless, those eyes fared no worse than the remainder of the cohort with respect to postoperative corrected distance visual acuity (CDVA), complications, or relief of DOD.…”

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confidence: 90%

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Clinical outcomes and complications following intraocular lens exchange in the setting of an open or intact posterior capsule

Alsetri

Masket

Fram

et al. 2023

J Cataract Refract Surg

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“…Despite unrelenting efforts towards calculating accurate IOL power and corneal toricity, while not necessarily reaching the level of a refractive surprise, a certain degree of off-target refractive results are consistently encountered [6,7]. However, correcting off-target refractive results require invasive procedures such as an IOL exchange or laser corneal ablation [8–12]…”

Section: Introductionmentioning

confidence: 99%

Light adjustable intraocular lenses in cataract surgery: considerations

Jun,

Lieu,

Afshari

2023

Current Opinion in Ophthalmology

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Purpose of review Light adjustable intraocular lens (LAL) is a promising concept in cataract surgery. This review explores considerations for the use of LALs. Recent findings Through updates, the safety of LALs and light delivery devices have been enhanced, enabling more efficient treatment with lower ultraviolet (UV) energy. Preoperative topography and aberration are essential for understanding indications for LALs. Furthermore, when determining intraocular lens power, it is crucial to factor in potential postoperative myopia or hyperopic adjustments. This is achieved by establishing a proper postimplantation refractive target and considering potential wavefront changes. Postoperative adjustments for defocus and astigmatism have demonstrated excellent outcomes. Monovision strategy by adjustable blended vision of LALs revealed distance vision of 20/20 along with near vision of J2 in 96% of patients. However, the results of clinical studies on postrefractive cataract surgery showed contrasting outcomes at distance, indicating the need for further research results regarding its effectiveness. A new postoperative workflow needs to be designed to enable a systematic follow-up process. Summary LALs are safe and demonstrate promising refractive outcomes. To achieve appropriate results, understanding the changes in optical characteristics associated with adjustment and constructing a new postoperative workflow are necessary.

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Diffractive optic intraocular lens exchange: indications and outcomes

Abstract: To assess indications and outcomes of surgical exchange of diffractive optic multifocal and extended depth-of-focus intraocular lenses (IOLs) in favor of monofocal IOLs.

Cited by 9 publications

References 18 publications

Surgical outcomes of intraocular lens iris suture fixation in eyes with residual capsule support

Surgical outcomes of intraocular lens iris suture fixation in eyes with residual capsule support

Clinical outcomes and complications following intraocular lens exchange in the setting of an open or intact posterior capsule

Light adjustable intraocular lenses in cataract surgery: considerations

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