Incidence of Intraoperative and Early Postoperative Adverse Events in a Large Cohort of Consecutive Refractive Lens Exchange Procedures

• Published in: American journal of ophthalmology 2019-12, Vol.208, p.406-414
• Main Authors: Schallhorn, Julie M., Schallhorn, Steven C., Teenan, David, Hannan, Stephen J., Pelouskova, Martina, Venter, Jan A.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Astigmatism; Cataracts; Device Removal; Eye surgery; Female; Follow-Up Studies; Humans; Incidence; Intraoperative Complications - epidemiology; Lasers; Lens Implantation, Intraocular - statistics & numerical data; Lenses, Intraocular; Male; Middle Aged; Multifocal Intraocular Lenses; Ophthalmology; Patients; Phacoemulsification; Postoperative Complications - epidemiology; Refraction, Ocular - physiology; Reoperation; Retrospective Studies; Surgeons; Visual Acuity - physiology
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/j.ajo.2019.08.025

To evaluate the incidence of adverse events (AEs) in patients who underwent refractive lens exchange. Retrospective case series. Setting: Private refractive surgery clinics. Patients/Study Population: Patients who underwent refractive lens exchange between July 1, 2014, and June 30, 2016. Intervention/Observation Procedures: All AEs recorded in the electronic medical record were extracted and retrospectively reviewed. The total incidence of AEs and serious AEs was calculated. Loss of 2 or more lines of corrected distance visual acuity (CDVA) was calculated for the entire cohort of patients that attended a minimum of 3 months follow-up. Main Outcome Measures: AEs. The total number of patients included was 10,206 (18,689 eyes). A multifocal intraocular lens (IOL) was implanted in 84.3% of eyes; 15.7% of eyes received a monofocal IOL. A total of 1164 AEs were recorded (1112 eyes of 1039 patients, incidence 6.0% of eyes, 1:17 eyes). The most common AE was posterior capsular opacification (PCO; 748 eyes, incidence 4.0%). Of all AEs, 171 events (occurring in 165 eyes of 151 patients, incidence 0.9%, 1:113 eyes) were classified as serious, potentially sight threatening. Loss of 2 or more lines of CDVA was 0.56% when excluding eyes where the loss of CDVA was due to PCO; the majority of these were due to macular causes. The incidence of sight-threatening AEs and significant loss of CDVA in elective refractive lens exchange surgery was low. Other than PCO, postoperative macular issues were the most common cause of vision loss in this cohort.