Clinical Evaluation of Macular Thickness Changes in Cataract Surgery Using a Light-Adjustable Intraocular Lens

To detect changes in retinal perfusion and macular thickness using fluorescein angiography and spectral-domain optical coherence tomography (OCT) before and after implantation of a Calhoun light-adjustable intraocular lens (Calhoun Vision, Pasadena, CA) and application of profiled doses of ultraviolet light for postoperative refractive adjustments.

This prospective trial of non-consecutive cases comprised 125 eyes of 125 patients who had cataract surgery and light-adjustable intraocular lens implantation. OCT examinations were performed preoperatively and postoperatively before first adjustment (10 to 14 days postoperatively) and 1 week (20 to 25 days postoperatively), 1 month (6 weeks postoperatively), 3 months (4 months postoperatively), and 12 months (13 months postoperatively) after lock-in. A control group of 104 eyes was evaluated for comparison.

One hundred twenty-two eyes at 12 months postoperatively were included and analyzed. Despite a general increase in macular thickness measurements overall during the first postoperative weeks, no changes to the integrity of inner segment/outer segment junction, outer nuclear layer, external limiting membrane, or retinal pigment endothelium were detected. The neuroretina returned to baseline by 3 months after surgery and there was no significant difference between preoperative and postoperative measurements after 3-month thickness values.

Ultraviolet light exposure for light-adjustable IOL adjustments did not influence the incidence of postoperative macular edema and did not induce any changes in the macular layers.