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Rachel Israilevich, Abtin Shahlaee, Mirataollah Salabati, Raziyeh Mahmoudzadeh, Taku Wakabayashi, Yoshihiro Yonekawa, Michael Klufas; Rhegmatogenous Retinal Detachment Repair Clinical Outcomes in Pseudophakic Eyes with Multifocal versus Monofocal Lenses. Invest. Ophthalmol. Vis. Sci. 2022;63(7):3435 – F0335.
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© ARVO (1962-2015); The Authors (2016-present)
To compare anatomic and visual acuity (VA) outcomes of rhegmatogenous retinal detachment (RRD) repair in pseudophakic eyes with multifocal versus monofocal intraocular lenses (IOLs).
This was a single-institution, retrospective case-control study evaluating all pseudophakic eyes with multifocal IOLs undergoing primary RRD repair with pars plana vitrectomy (PPV) or PPV with scleral buckle (PPV+SB) from 1/1/13-9/1/21. A 1:1 monofocal IOL control group was matched based on age, gender, macula status, primary surgeon, and timing of surgery. Eyes with baseline PVR were excluded. Outcomes included single surgery anatomic success (SSAS) rate at 90 days after surgery, and VA at baseline and final visit after primary RRD repair.
Seventy-one eyes had multifocal IOLs at primary RRD surgery during the study period and were eligible for analysis. Both the multifocal and control groups included 71 eyes, and mean age was 64.8 ± 8.5 and 64.5 ± 8.8 years, respectively (p=0.85). Primary PPV and PPV+SB was performed on 66 (93%) and 5 (7%) multifocal eyes, respectively, vs. 60 (84.5%) and 11 (15.5%) control eyes (p=0.11). Mean follow-up was 773 ± 588 days in the multifocal group vs. 793 ± 565 days in the control group (p=0.84). Overall SSAS was achieved in 55 (77.5%) multifocal eyes vs. 63 (88.7%) control eyes (p=0.073). Primary PPV and PPV+SB resulted in SSAS in 50 (75.8%) and 5 (100%) multifocal eyes vs. 53 (88.3%) and 10 (90.9%) control eyes (p=0.068, p=1.00, respectively). In surgical failures, the mean number of RRD surgeries was 2.4 ± 0.7 in the multifocal group vs. 2.1 ± 0.4 in the control group (p=0.33). Mean baseline logMAR VA was 0.95 ± 0.89 (20/178) in multifocal eyes vs. 0.95 ± 0.92 (20/178) in control eyes (p=0.84), and at final visit was 0.27 ± 0.34 (20/37) in multifocal eyes vs. 0.28 ± 0.43 (20/38) in control eyes (p=0.83). The most common cause of surgical failure in both groups was post-operative PVR which developed in 8 (53.5%) of multifocal and 5 (71.4%) of control failures (p=0.65).
In pseudophakic RRDs undergoing primary surgical repair, there was a trend towards higher SSAS in eyes with monofocal IOLs, but no statistically significant difference in SSAS or PVR development in eyes with multifocal vs. monofocal IOLs. Visual outcomes were similar in both groups and significantly improved compared to baseline.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.
Anatomical and visual outcomes.
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