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

Abstract

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.

A Randomized, Controlled, Prospective Study of the Effectiveness and Safety of an Intracanalicular Dexamethasone Ophthalmic Insert (0.4 Mg) for the Treatment of Post-Operative Inflammation in Patients Undergoing Refractive Lens Exchange (RLE)

“…Of note, younger patients and those with longer axial lengths had an increased risk for increased steroid response. 8 , 9 In our study, 2/40 eyes (5%) of patients developed steroid induced ocular hypertension, all of which self-resolved without complication. This higher rate could be related to the younger age of our patient population, their relative pre-operative myopia, or small sample size.…”

Visual Acuity Outcomes after Phacoemulsification in Eyes with Good Visual Acuity before Cataract Surgery

“…Moreover, second eye cataract surgery can be performed earlier due to anisometropia after first eye surgery [7]. Clear lens or early cataract extraction with multifocal IOL implantation may also be offered to patients as a means to correct presbyopia [16,17]. However, intraoperative complications (such as posterior capsule rupture, zonular dehiscence, and iris trauma) or post-operative complications (such as posterior capsule opacification, cystoid macular oedema, or retinal detachment especially in long eyes) may adversely affect outcomes of cataract surgery [18][19][20][21].…”

Methods for evaluating quality of life and vision in patients undergoing lens refractive surgery

“…Finally, self-developed questionnaires are commonly applied, with questions regarding the level of patient satisfaction with surgical outcome, level of spectacle independence, and difficulties performing vision-related activities after surgery [37][38][39]. For example, the Spectacle Independence Lens Vision Evaluation and Repurchase (SILVER) questionnaire is one example that was developed by a sponsor, but which cannot be determined as a valid assessment of "spectacle independence" [17].…”