Weigh four areas before considering anterior chamber IOL in cases without capsular support
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NEW ORLEANS — When considering an anterior chamber IOL as an option for patients who lack capsular support, there are four considerations that can guide the decision-making process, according to a speaker here.
“What we’ve done is we have looked at the four main things to consider with ACIOLs,” Kendall E. Donaldson, MD, MS, said during Glaucoma Subspecialty Day at the American Academy of Ophthalmology meeting.
The first factor to consider is the age of the patient, followed by anterior chamber depth, endothelial cell count and retina issues. In this system, each point of consideration is evaluated based on the risk factor they represent, ranging from 0 to 4 points.
“A patient gets 4 points if they are under the age of 50, 3 points if they are between the ages of 50 and 69, and zero points if they are over the age of 90,” Donaldson said. Patients between 70 and 79 years receive 2 points, and patients between 80 and 89 years receive 1 point.
Patients with low endothelial cell counts, shallow anterior chamber depths and recurrent retina issues receive 4 points for each consideration, with endothelial cell count greater than 2,500 cells/mm2, anterior chamber depth greater than 3.5 mm and no retina issues receiving 0 points.
“Basically, we add these together to make the ACIOL risk score,” Donaldson said.
Low-risk patients, in which an anterior chamber IOL may be considered, score between 0 and 4 points. Patients who score between 13 and 16 points should never be considered for an anterior chamber IOL.
“I think we should reconsider ACIOLs in very specific cases,” Donaldson said.
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Donaldson KE. ACIOLs in cases lacking capsular support: Is there still a role? Presented at: American Academy of Ophthalmology meeting; Nov. 12-15, 2021; New Orleans.
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