Intraocular Lens Exchange For Primary Calcification: A Clinical Study
Published 2023 - 41st Congress of the ESCRS
Reference: FP13.04 | Type: Free paper | DOI: 10.82333/34xb-v049
Authors: Timur Mert Yildirim* 1 , Nikola Henningsen 1 , Hyeck-Soo Son 1 , Victor Augustin 1 , Grzegorz Labuz 1 , Maximilian Köppe 1 , Ramin Khoramnia 1 , Gerd Auffarth 1
1Department of Ophthalmology,Heidelberg University Hospital,Heidelberg,Germany
Purpose
Patients with intraocular lens (IOL) calcification are often subjectively impaired, although they may still have good visual acuity. Therefore, further factors limiting the quality of vision should be investigated. The aim of this study was to evaluate subjective and objective parameters following IOL surgery due to primary IOL calcification.
Setting
The David J Apple Center for Vision Research, Department of Ophthalmology, Heidelberg University Hospital, Heidelberg, Germany
Methods
In this prospective, clinical, monocentric study, 43 eyes of 33 patients with primary IOL calcification were included. The following parameters were assessed preoperatively (T0) and three months after IOL exchange (T1): general subjective symptoms, impairment by photic phenomena using a halo and glare simulator, a standardized quality of life questionnaire (Catquest-9SF), as well as the corrected distance visual acuity (CDVA), straylight value (C-quant, Oculus, Wezlar, Germany) and contrast sensitivity with and without glare (CSV-1000, VectorVision, Houston, USA).
Results
IOL exchange surgery was performed in 24 out of 43 cases. An iris-fixated IOL used in 58% of cases, a sulcus-supported IOL in 38%, and a capsular bag-supported IOL in 4% of cases. The average halos decreased in size and intensity, as did glare. Subjective improvement in quality of life was also seen in the Catquest-9SF results. Objectively, there was a significant improvement in the CDVA from 0.14 to 0.02 logMAR, as well as in contrast sensitivity with and without glare. The straylight value decreased significantly and clinically relevant from 2.46 to 1.27 log(s).
Conclusions
Although primary IOL calcification is not always associated with reduced visual acuity, IOL exchange is a reasonable intervention in many cases, improving subjective complaints and quality of life in affected patients. Visual acuity should not be used as the sole functional outcome parameter as the intraocular straylight value and contrast sensitivity, especially under glare, can better objectify the actual change in the visual quality of patients with IOL calcification.