Incidence of Intraoperative and Early Postoperative Adverse Events in a Large Cohort of Consecutive Refractive Lens Exchange Procedures

Schallhorn, Julie M.; Schallhorn, Steven C.; Teenan, David; Hannan, Stephen J.; Pelouskova, Martina; Venter, Jan A.

doi:10.1016/j.ajo.2019.08.025

Cited by 16 publications

(7 citation statements)

References 27 publications

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“…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]. Even in uncomplicated surgery, visual symptoms like halos, night glare, and starbursts are not uncommon, especially with premium intraocular lenses, and these may sometimes result in unhappy patients post-operatively [22].…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2021

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Objective: To analyze cataract surgery outcomes and related factors in eyes presenting with good visual acuity. Subject and Methods: Retrospective longitudinal of patients undergoing phacoemulsification between the years 2014-2018 in Moorfields Eye Hospital and satellite units. Pre- and postoperative visual acuity (unaided, with glasses, with pinhole) were analyzed. Inclusion criteria were age≥40 years and pinhole visual acuity ≥6/9 preoperatively. Exclusion criteria were no postoperative visual acuity data. VA change variable was also defined according to postoperative visual acuity being above or below the Snellen 6/9 threshold. Results: 2720 eyes were included in the analysis. The unaided LogMAR visual acuity improved from 0.54 to 0.20 (p<0.001), the LogMAR visual acuity with glasses improved from 0.35 to 0.05(p<0.001) and the LogMAR pinhole visual acuity improved from 0.17 to 0.13(p<0.001). 8.1% of patients had Snellen visual acuity <6/9 postoperatively. Mean follow up period was 23,6±9.9 days. In multivariate logistic regression, factors associated with visual acuity <6/9 postoperatively were: age [OR=0.96, 95% CI (0.95, 0.98), p<0.001], vitreous loss [OR=0.21, 95% CI (0.08, 0.56), p=0.002] and iris trauma [OR=0.28, 95% CI (0.10, 0.82) p=0.02]. No significant adverse events occurred. Conclusions: Visual acuity improved significantly overall in this group of patients, although at least 8.1% of them did not reach their pinhole preoperative visual acuity. Worse visual acuity outcomes were associated with increasing age, vitreous loss and iris trauma. The 6/9 vision threshold may not be able to accurately differentiate those who may benefit from cataract surgery and those who may not.

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Section: Discussionmentioning

confidence: 99%

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

et al. 2021

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“…[3][4][5] The procedure is referred to as "clear lens extraction (CLE)", and advances in this technology have enabled it to become a popular refractive procedure. [6][7][8][9][10] MIOLs can induce aberrant light perception disturbances; 11 thus, motivation to achieve spectacle freedom must outweigh the potential adverse effects. Vision-related quality of life (VRQoL) improves with MIOLs, [12][13][14] but we do not know if overall health-related quality of life (HRQoL) changes after CLE and MIOL implantation.…”

Section: Introductionmentioning

confidence: 99%

One-year Results of Health-related and Vision-related Quality of Life After Clear Lens Extraction and Multifocal Intraocular Lens Implantation

Koskela¹,

Koskela²,

Tuuminen

et al. 2021

American Journal of Ophthalmology

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…The emergence of a wide range of IOLs, including monofocal, extended depth-of-focus (EDOF), and multifocal with multifocal effects, make refractive lens exchange one of the most popular treatments for presbyopia [20]. Although multifocal IOLs increase spectacle independence and yield good visual results for near and distance vision, the main complications consist of an unpredictable neuroadaptation process, the presence of halos, and glare [17,21]. With a monofocal alternative, using correction for emmetropia in the dominant eye and a selected degree of myopia in the non-dominant eye, it is possible to have successful visual results, with less dysphotopsia symptoms than with multifocal IOLs, but at the cost of stereopsis and reduced contrast sensitivity [22].…”

Section: Introductionmentioning

confidence: 99%

Overview of pharmacological treatments for presbyopia

Orman¹,

Benozzi²

2021

Med Hypothesis Discov Innov Optom

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Background: Presbyopia is the normal progressive waning of accommodation with loss of the visual ability to focus on objects residing at different distances. Presbyopia exacts a cost in quality of life and professional efficiency of many people over 40 years of age. Presbyopia is likely to be 1 of the main pressing visual concerns of the 21st century, given that life expectancy is increasing, resulting in an aging population. This review aimed to address the 3 strategies of the pharmacological treatment for presbyopia. Methods: A review on PubMed/MEDLINE, Google Scholar, and Clinicaltrials.gov was performed to investigate the English literature on pharmacological treatment for presbyopia from beginning-of-year 2012 to September 30, 2020. Results: In addition to the treatment of presbyopia with glasses or contact lenses, new surgical strategies have been developed, some of which have been successful. However, during the last decade, a new, promising, non-invasive option for treating presbyopia has emerged: the pharmacological approach. Many researchers have developed 3 different lines of investigation from different assumptions, on a pharmacological basis. The first consisted of producing miosis, to take advantage of a pharmacologically induced pinhole effect, increasing depth-of-focus, and thus improving uncorrected near visual acuity. The second aimed to rehabilitate accommodation binocularly to enable good vision at all distances. Finally, the third approach attempted to rehabilitate lost elasticity in the human crystalline lens. Conclusions: None of the 3 discussed pharmacological strategies for treating presbyopia, prescribed globally, but patients of restoring accommodation strategy can adhere locally, where they are sold so far as master prescriptions.

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Incidence of Intraoperative and Early Postoperative Adverse Events in a Large Cohort of Consecutive Refractive Lens Exchange Procedures

Cited by 16 publications

References 27 publications

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

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

One-year Results of Health-related and Vision-related Quality of Life After Clear Lens Extraction and Multifocal Intraocular Lens Implantation

Overview of pharmacological treatments for presbyopia

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