PMID- 37086858
OWN - NLM
STAT- MEDLINE
DCOM- 20230822
LR  - 20230929
IS  - 1549-4713 (Electronic)
IS  - 0161-6420 (Linking)
VI  - 130
IP  - 9
DP  - 2023 Sep
TI  - Immediate Sequential Bilateral Surgery in Refractive Lens Exchange Patients: 
      Clinical Outcomes and Adverse Events.
PG  - 924-936
LID - S0161-6420(23)00279-8 [pii]
LID - 10.1016/j.ophtha.2023.04.013 [doi]
AB  - PURPOSE: To evaluate outcomes and the incidence of adverse events (AEs) in 
      patients who underwent bilateral same-day refractive lens exchange (RLE). DESIGN: 
      Retrospective case series. PARTICIPANTS: Patients of a private intraocular 
      surgery provider in the United Kingdom who underwent RLE in both eyes on the same 
      day with treatment dates between March 2018 and December 2021. METHODS: Clinical 
      outcomes and AEs were collected for a continuous cohort of patients undergoing 
      bilateral same-day RLE (in the absence of visually significant cataracts) or had 
      mild cataracts (corrected visual acuity >/= 20/40). One-month clinical outcomes 
      were analyzed. MAIN OUTCOME MEASURES: Refractive outcomes and visual acuity, 
      intraoperative and postoperative AEs, and secondary surgical interventions 
      recorded within the first month after surgery. RESULTS: A total of 17 330 
      patients (34 660 eyes) were included in the analysis. Of these, 28 827 eyes 
      received a multifocal intraocular lens (IOL), and 5833 eyes had a monofocal IOL. 
      The percentage of eyes within +/-0.50 diopters (D) of intended refraction was 85.5% 
      and 86.2% for monofocal and multifocal IOL eyes, respectively. There was a total 
      of 55 intraoperative AEs recorded in 55 eyes of 54 patients (per-eye incidence: 
      0.159%). Posterior capsule tear was the most common intraoperative event 
      occurring in 37 eyes (0.107%). The number of AEs recorded within the first 
      postoperative month was 267, occurring in 263 eyes of 177 patients (per-eye 
      incidence: 0.759%). These included cystoid macular edema (CME) (172 eyes; 
      0.496%), significant corneal edema (28 eyes; 0.081%), persistent inflammation (27 
      eyes; 0.078%), significantly raised intraocular pressure (27 eyes; 0.078%), toxic 
      anterior segment syndrome (8 eyes; 0.023%), wound leak (3 eyes; 0.009%), retinal 
      detachment (1 eye; 0.003%), and retinal tear (1 eye; 0.003%). There were 56 
      secondary surgical interventions recorded within the first month of surgery, 
      occurring in 54 eyes of 47 patients (per-eye incidence: 0.156%). The most common 
      secondary intervention was the rotation of a misaligned toric IOL (24 eyes; 
      0.069%). CONCLUSIONS: Elective same-day bilateral RLE had a low incidence of 
      serious AEs, and high refractive predictability. FINANCIAL DISCLOSURE(S): 
      Proprietary or commercial disclosure may be found in the Footnotes and 
      Disclosures at the end of this article.
CI  - Copyright (c) 2023 American Academy of Ophthalmology. Published by Elsevier Inc. 
      All rights reserved.
FAU - Hannan, Stephen J
AU  - Hannan SJ
AD  - Optical Express, Glasgow, United Kingdom.
FAU - Schallhorn, Steven C
AU  - Schallhorn SC
AD  - Optical Express, Glasgow, United Kingdom; University of California, San 
      Francisco, Department of Ophthalmology, San Francisco, California; Carl Zeiss 
      Meditec, Inc., Dublin, California.
FAU - Venter, Jan A
AU  - Venter JA
AD  - Optical Express, Glasgow, United Kingdom.
FAU - Teenan, David
AU  - Teenan D
AD  - Optical Express, Glasgow, United Kingdom.
FAU - Schallhorn, Julie M
AU  - Schallhorn JM
AD  - University of California, San Francisco, Department of Ophthalmology, San 
      Francisco, California; F.I. Proctor Foundation, University of California, San 
      Francisco, California. Electronic address: Julie.schallhorn@ucsf.edu.
LA  - eng
PT  - Journal Article
DEP - 20230420
PL  - United States
TA  - Ophthalmology
JT  - Ophthalmology
JID - 7802443
SB  - IM
MH  - Humans
MH  - Retrospective Studies
MH  - Lens Implantation, Intraocular
MH  - Visual Acuity
MH  - Refraction, Ocular
MH  - *Lenses, Intraocular/adverse effects
MH  - *Cataract
MH  - *Phacoemulsification/adverse effects
OTO - NOTNLM
OT  - Immediate sequential bilateral surgery
OT  - Refractive lens exchange
OT  - Secondary interventions
OT  - Surgical adverse events
EDAT- 2023/04/23 00:41
MHDA- 2023/08/22 06:43
CRDT- 2023/04/22 19:25
PHST- 2023/01/18 00:00 [received]
PHST- 2023/04/06 00:00 [revised]
PHST- 2023/04/13 00:00 [accepted]
PHST- 2023/08/22 06:43 [medline]
PHST- 2023/04/23 00:41 [pubmed]
PHST- 2023/04/22 19:25 [entrez]
AID - S0161-6420(23)00279-8 [pii]
AID - 10.1016/j.ophtha.2023.04.013 [doi]
PST - ppublish
SO  - Ophthalmology. 2023 Sep;130(9):924-936. doi: 10.1016/j.ophtha.2023.04.013. Epub 
      2023 Apr 20.