Patients willing to consider elective lens exchange surgery can rest a little easier knowing the decision isn’t likely to lead to adverse events. A recent study found a low occurrence of adverse events or major visual acuity loss following the procedure. The large cohort investigation found the most common problem after surgery was posterior capsular opacification at just 4%. Macular issues were the other most common cause of vision loss.

The retrospective case series included 18,689 eyes that underwent refractive lens exchange in private refractive surgery clinics over a two-year period. The investigators calculated the loss of two or more lines of corrected distance visual acuity for the patients who had at least a three-month follow-up.

The researchers noted most eyes, 84.3%, had a multifocal IOL while the other 15.7% received a monofocal IOL. Post surgery, the study found a total of 1,164 adverse events (6% incidence), with 171 deemed serious and potentially sight threatening (an incidence of 0.9%). Posterior capsular opacification occurred in 748 eyes.

The study also reported the loss of two or more lines of corrected distance visual acuity in 0.56% of eyes when excluding those for whom the loss was due to posterior capsular opacification. The investigators noted the majority of these cases were due to macular causes.

Schallhorn JM, Schallhorn SC, Teenan D, Hannan SJ, et al. Incidence of intraoperative and early postoperative adverse events in a large cohort of consecutive refractive lens exchange procedures. Am J Ophthalmol. September 4, 2019. [Epub ahead of print].