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Light adjustable lens implantation with cataract surgery in eyes with macular pathology
Collin Olevson1, Brent Kramer, Daniel C Terveen
1From the University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota (Olevson, Kramer, Terveen, Berdahl, Thompson, Ferguson); Vance Thompson Vision, Sioux Falls, South Dakota (Kramer, Terveen, Berdahl, Thompson, Ferguson).
Purpose:
To evaluate the visual, refractive, and safety outcomes of the light adjustable lens (LAL) in eyes with preexisting macular pathology undergoing cataract surgery.
Setting:
Private practice, multiple locations.
Design:
Retrospective, consecutive case series.
Methods:
Patients with macular pathology undergoing cataract surgery with LAL implantation were included. Diagnoses comprised epiretinal membrane (ERM), dry age-related macular degeneration (AMD)/drusen, and other macular conditions. Primary outcome measures included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and the percentage of eyes within ±0.25 diopter (D), ±0.50 D, and ±1.00 D of the refractive target. Safety endpoints included intraoperative and postoperative complications and changes in CDVA preadjustments and postadjustments.
Results:
171 eyes from 106 patients were included. The most common diagnoses were ERM and dry AMD. Among eyes targeted for distance (n = 95), 96% achieved UDVA of 20/25 or better and 85% achieved 20/20 or better. For refractive accuracy, 87% of eyes were within ±0.50 D and 68% were within ±0.25 D of the target. The percentage of eyes within ±0.50 D of target rose from 66% to 87% after the adjustment process, and the percentage of eyes achieving 20/20 or better climbed from 26% to 85%.
Conclusions:
In eyes with macular pathology, the LAL provides excellent uncorrected visual acuity and highly accurate refractive outcomes with a favorable safety profile. These findings position the LAL as a viable advanced IOL option in patients traditionally considered suboptimal candidates due to underlying macular disease.
