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Jose A Nava, Martha Cecilia López-Montero, Jorge E Valdez; Visual Outcomes of presenile cataract surgery compared with Refractive Lens Exchange in Mexican population. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4799. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Evaluate safety and efficacy of refractive lens exchange in a group of presbyopic adult patients compared with a group of pre-senile cataract patients who underwent phacoemulsification
A group of 73 patients with presbyopia who were offered to undergo refractive lens exchange were grouped in a cohort and compared with a cohort of 72 patients with presenile cataract who underwent phacoemulsification with a monofocal intraocular lens implant in a clinic in northeastern Mexico. Pre-and postoperative visual acuity were evaluated as well as the presence of complications. Patients with severe ocular comorbidities or previous refractive surgery were excluded.
A total of 145 patients were selected, which were divided into 2 cohorts. The first cohort was composed of 73 patients interested in lens refractive exchange and the second one of 72 patients with pre-senile cataracts. In the cohort of those interested in phacorrefractive surgery, 39 of them were women (53%) and 34 men (47%), while in the cohort of presenile cataracts, 46 were women (63.3%) and 26 men (36.6%). The uncorrected visual acuity (UCVA) of the first cohort was .44 logMar, while the best corrected visual acuity (BCVA) reached .05 logMar, which postoperatively reached an UCVA of .02 logMar and BCVA .004 logMar. In the pre-senile cataract cohort, the UCVA was 1.48 logMar, which BCVA improved to .57 logMar, after surgery the UCVA was .23 logMar that in BCVA improved to .04 logMar. In this group, 10.9% (8 patients) had some degree of diabetic retinopathy and 17% (13) myopia magna; in 3 cases (4%) cataract was of traumatic origin, but the patients with the worst improvement in their visual acuity were the group with myopia magna. The incidence of complications was similar (1 case of endophthalmitis in both groups)
Refractive lens exchange for patients with presbyopia and phacoemulsification for pre-senile cataract proved to be equally safe and the incidence of complications was similar in both groups. Candidates for refractive lens exchange must be carefully evaluated but could be an alternative for patients who wish to correct presbyopia.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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