Refractive lens exchange in younger and older presbyopes: comparison of complication rates, 3 months clinical and patient-reported outcomes

Abstract

Purpose

To compare refractive and visual outcomes, patient satisfaction, and complication rates among different age categories of patients who underwent refractive lens exchange (RLE).

Methods

A stratified, simple random sample of patients matched on preoperative sphere and cylinder was selected for four age categories: 45–49 years (group A), 50–54 years (group B), 55–59 years (group C), and 60–65 years (group D). Each group contained 320 patients. All patients underwent RLE with a multifocal intraocular lens at least in one eye. Three months postoperative refractive/visual and patient-reported outcomes are presented.

Results

The percentage of patients that achieved binocular uncorrected distance visual acuity 20/20 or better was 91.6% (group A), 93.8% (group B), 91.6% (group C), 88.8% (group D), P=0.16. Binocularly, 80.0% of patients in group A, 84.7% in group B, 78.9% in group C, and 77.8% in group D achieved 20/30 or better uncorrected near visual acuity (P=0.13). The proportion of eyes within 0.50 D of emmetropia was 84.4% in group A, 86.8% in group B, 85.7% in group C, and 85.8% in group D (P=0.67). There was no statistically significant difference in postoperative satisfaction, visual phenomena, dry eye symptoms, distance or near vision activities. Apart from higher rate of iritis in the age group 50–55 years, there was no statistically significant difference in postoperative complication rates.

Conclusion

RLE can be safely performed in younger as well as older presbyopes. No significant difference was found in clinical or patient-reported outcomes.

Keywords:

• refractive lens exchange
• multifocal IOLs
• younger/older presbyopes

Supplementary materials

Table S1 Postoperative patient-reported outcomes according to age category

Table S2 Patient-reported outcomes: difference between postoperative and preoperative scores

Disclosure

Steven C Schallhorn is a chief medical officer for Zeiss, consultant for Acufocus, and a chairman of the medical advisory board for Optical Express. Julie M Schallhorn has been a member of the advisory board for Malinckrodt Pharmaceuticals and received a lecture honorarium payment from Avellino Labs. None of the other authors have a financial or proprietary interest in the products and materials presented in this paper.