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Patients with presbyopia or nonfunctioning lens may benefit from clear lens surgery
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NEW ORLEANS — Clear lens surgery may be a better option for patients with presbyopia or a nonfunctional lens than PRK, LASIK or phakic IOL surgery, according to a speaker here.
“Consider removing the lens when the lens is not functioning, particularly in myopic presbyopes, hyperopic presbyopes and hyperopic patients where refractive surgery falls short. In the future we may see further expansion into this space,” William F. Wiley, MD, said at Refractive Surgery Subspecialty Day preceding the American Academy of Ophthalmology meeting.
Advancements in safety, biometry and removal techniques have increased the functional use of lens-based surgery. Intraocular antibiotics have made the surgery safer, femtosecond lasers have made it more precise, and intraoperative aberrometry has made it more accurate. Additionally, advanced technology IOLs can give patients both distance and near vision, while many new lenses can also treat presbyopia and myopia, Wiley said.
Presbyopic patients with lens dysfunction are better candidates for the procedure than younger patients with functional lenses. Patients in whom the refractive error is more concerning than their age are also possible candidates for lens exchange surgery, Wiley said.
The main concern with clear lens surgery is the increased risk for retinal detachment. The risk increases in younger patients, male patients and those with axial lengths greater than 26 mm, and also if the posterior vitreous is not detached, he said.
As technology gets better in the future, new lenses will be upgradeable or exchangeable, and light-adjustable lenses will be available, Wiley said. – by Robert Linnehan
Reference:
Wiley WF. Refractive lens exchange: When to remove the lens? Presented at AAO Subspecialty Days; Nov. 10-11, 2017; New Orleans.
Disclosure: Wiley reports he is a consultant for Abbott Medical Optics, AcuFocus, Alcon Laboratories, Allergan, Cassini, Equinox, Iantech, Imprimis, Ivantis, Lensar, New World Medical, Omega Lens, ReVision Optics and Zeiss; receives lecture fees from Abbott Medical Optics, Alcon Laboratories and Lensar; receives grant support from Calhoun Vision and Presbia; is an equity owner with Alphaeon and Equinox; and has patents/royalty with Imprimis.