Epidemiology and outcomes in refractive lens exchange surgery

Westin, Oscar; Koskela, Timo; Behndig, Anders

doi:10.1111/aos.12460

Cited by 32 publications

(20 citation statements)

References 15 publications

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“…As such, one would expect similar objective outcomes although subjective patient reporting might be expected to be slightly worse for the RLE cases, since they have been reported to have higher expectations relative to their vision after IOL implantation 19. We did not see any subjective differences in our study.…”

Section: Discussionmentioning

confidence: 50%

Trifocal intraocular lenses: a comparison of the visual performance and quality of vision provided by two different lens designs

Gundersen

Potvin²

2017

OPTH

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PurposeTo compare two different diffractive trifocal intraocular lens (IOL) designs, evaluating longer-term refractive outcomes, visual acuity (VA) at various distances, low contrast VA and quality of vision.Patients and methodsPatients with binocularly implanted trifocal IOLs of two different designs (FineVision [FV] and Panoptix [PX]) were evaluated 6 months to 2 years after surgery. Best distance-corrected and uncorrected VA were tested at distance (4 m), intermediate (80 and 60 cm) and near (40 cm). A binocular defocus curve was collected with the subject’s best distance correction in place. The preferred reading distance was determined along with the VA at that distance. Low contrast VA at distance was also measured. Quality of vision was measured with the National Eye Institute Visual Function Questionnaire near subset and the Quality of Vision questionnaire.ResultsThirty subjects in each group were successfully recruited. The binocular defocus curves differed only at vergences of −1.0 D (FV better, P=0.02), −1.5 and −2.00 D (PX better, P<0.01 for both). Best distance-corrected and uncorrected binocular vision were significantly better for the PX lens at 60 cm (P<0.01) with no significant differences at other distances. The preferred reading distance was between 42 and 43 cm for both lenses, with the VA at the preferred reading distance slightly better with the PX lens (P=0.04). There were no statistically significant differences by lens for low contrast VA (P=0.1) or for quality of vision measures (P>0.3).ConclusionBoth trifocal lenses provided excellent distance, intermediate and near vision, but several measures indicated that the PX lens provided better intermediate vision at 60 cm. This may be important to users of tablets and other handheld devices. Quality of vision appeared similar between the two lens designs.

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Section: Discussionmentioning

confidence: 50%

Trifocal intraocular lenses: a comparison of the visual performance and quality of vision provided by two different lens designs

Gundersen

Potvin²

2017

OPTH

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“…Although more and more surgeons are opting to perform RLE on presbyopes younger than 50 years, 12 – 14 to our knowledge, no study has specifically compared the visual, refractive, and quality of life outcomes among different age categories of RLE patients. Younger presbyopes are more active, working-age patients with high visual requirements for near and intermediate vision.…”

Section: Discussionmentioning

confidence: 99%

Refractive lens exchange in younger and older presbyopes: comparison of complication rates, 3 months clinical and patient-reported outcomes

Schallhorn¹,

Schallhorn²,

Pelouskova³

et al. 2017

OPTH

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PurposeTo compare refractive and visual outcomes, patient satisfaction, and complication rates among different age categories of patients who underwent refractive lens exchange (RLE).MethodsA stratified, simple random sample of patients matched on preoperative sphere and cylinder was selected for four age categories: 45–49 years (group A), 50–54 years (group B), 55–59 years (group C), and 60–65 years (group D). Each group contained 320 patients. All patients underwent RLE with a multifocal intraocular lens at least in one eye. Three months postoperative refractive/visual and patient-reported outcomes are presented.ResultsThe percentage of patients that achieved binocular uncorrected distance visual acuity 20/20 or better was 91.6% (group A), 93.8% (group B), 91.6% (group C), 88.8% (group D), P=0.16. Binocularly, 80.0% of patients in group A, 84.7% in group B, 78.9% in group C, and 77.8% in group D achieved 20/30 or better uncorrected near visual acuity (P=0.13). The proportion of eyes within 0.50 D of emmetropia was 84.4% in group A, 86.8% in group B, 85.7% in group C, and 85.8% in group D (P=0.67). There was no statistically significant difference in postoperative satisfaction, visual phenomena, dry eye symptoms, distance or near vision activities. Apart from higher rate of iritis in the age group 50–55 years, there was no statistically significant difference in postoperative complication rates.ConclusionRLE can be safely performed in younger as well as older presbyopes. No significant difference was found in clinical or patient-reported outcomes.

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“…Since the introduction of MIOLs, presbyopia can be corrected by crystalline lens exchange, that is, RLE [ 15 ]. Patients who undergo RLE generally are younger [ 5 ] and have higher expectations regarding refractive and visual outcomes than those with cataracts. To enable patients to be spectacle-free while engaging in daily activities, the MIOL must provide adequate functional vision at various distances.…”

Section: Discussionmentioning

confidence: 99%

“…However, the intermediate vision, which is important for most people in daily activities, for example, computer use, shopping, and cooking, was rarely reported [ 3 ]. Westin et al [ 5 ] compared a group of patients who underwent RLE in a clinic setting with a population from a cataract surgery registry and found that the former group was significantly younger. Since younger presbyopic patients seeking RLE are less likely to have complaints at intermediate distance and implantation of diffractive bifocal MIOLs can lead to the loss of natural accommodation, the overall impact of RLE is unknown.…”

Section: Introductionmentioning

confidence: 99%

Visual Outcomes and Patient Satisfaction after Refractive Lens Exchange with a Single-Piece Diffractive Multifocal Intraocular Lens

Chang

Chan

et al. 2014

Journal of Ophthalmology

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Purpose. To report visual outcomes and patient satisfaction after unilateral or bilateral refractive lens exchange (RLE) with a single-piece bifocal diffractive multifocal intraocular lens (MIOL). Methods. All patients underwent RLE with the ZMB00 MIOL (Abbott Medical Optics). Patient charts were reviewed to evaluate the distance, intermediate, and near visual acuity (VA), contrast sensitivity, extent of visual symptoms (0–5), satisfaction (1–5), and rate of spectacle independence between unilateral and bilateral RLE group. Results. Forty-seven eyes of 28 patients were included. No intraoperative complications developed. Mean monocular uncorrected VA at distance, intermediate (67 cm), and near (30 cm) were 0.01 ± 0.12 (standard deviation), 0.27 ± 0.18, and 0.15 ± 0.11, respectively. No eyes lost >1 line of corrected distance VA. Monocular contrast sensitivity remained at normal level. Median scores of halos, night glare, and starbursts for 27 patients were 2.0, 3.0, and 0.0, respectively. Median score of satisfaction was 4.0. There were no differences in visual symptom scores or satisfaction between unilateral and bilateral group (P > 0.05). Eighty percent of 25 patients reported total spectacle freedom, with similar rate between bilateral (82%) and unilateral group (75%) (P = 1.000). Conclusions. RLE with the bifocal diffractive MIOL was safe in presbyopic patients and resulted in a high rate of spectacle independence.

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Epidemiology and outcomes in refractive lens exchange surgery

Cited by 32 publications

References 15 publications

Trifocal intraocular lenses: a comparison of the visual performance and quality of vision provided by two different lens designs

Trifocal intraocular lenses: a comparison of the visual performance and quality of vision provided by two different lens designs

Refractive lens exchange in younger and older presbyopes: comparison of complication rates, 3 months clinical and patient-reported outcomes

Visual Outcomes and Patient Satisfaction after Refractive Lens Exchange with a Single-Piece Diffractive Multifocal Intraocular Lens

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