Analysis Of Results After Combined Cataract Surgery And Transscleral Micropulse Laser Therapy (Mp-Tlt) With An Enhanced Monofocal Lens Implantation

The purpose of this study is to present the effect of the combined cataract procedure and transscleral micropulse laser therapy (MP-TLT) with the use of the enhanced monofocal RayOne EMV IOL (RAO200E, Rayner). Primary outcomes were the change in intraocular pressure (IOP), uncorrected distance visual acuity (UDVA), anterior chamber depth (ACD) and the width of the iridocorneal angle.

District Health Care Facility Complex in Bedzin, Ophthalmology Ward, Poland

WSB University, Dabrowa Gornicza, Poland

In this prospective single-center study cataract removal with phacoemulsification was performed with implantation of a RayOne EMV IOL with the target refraction emmetropia defined as closest to zero. Then, MP-TLT was performed using Cyclo G6 (IRIDEX, Mountain View, CA, USA). Preoperatively, 1 day, 1 week, 2 months and 6 months after the procedure, CDVA, UDVA, UIVA, UNVA, iridocorneal angle width, ACD and IOP were measured. Changes in CDVA, UIVA, UNVA will be known in secondary outcomes. Exclusion criteria: astigmatism >1.0 D, lens subluxation, diseases of the retina and nerve II, previous ophthalmological surgery, corneal diseases, active inflammatory process around the eye.

Preliminary data of 15 eyes of 14 patients after 2 weeks observation (in a total of 20 eyes, and 6 months follow up) were available for evaluation. A statistically significantly increase in ACD from 2.94±0.41 mm preoperatively to 3.74±0.53 mm postoperatively by 0.8mm (p<0.001) was observed. The IOP decreased from 21.26±2.6 mmHg preoperatively to 15.13±1.78 mmHg postoperatively by 6.13 mmHg (p<0.001). Before the procedure mean irido-corneal angle was 25.53±6.03 degrees and after surgery 31.88±6.27 degrees and widened statistically significantly by 6.35 degrees (p<0.001). Monocular UDVA improved statistically significantly from 1.14±0.82 logMAR preoperatively to 0.09±0.07 logMAR postoperatively by 1.05 logMAR (p<0.001).

Postoperatively, all patients experienced a decrease in intraocular pressure and a statistically significant improvement in visual acuity at all tested distances. Deepening of the anterior chamber and widening of the filtration angle were also noted. The simultaneous use of a combined cataract removal procedure and MP-TLT using RayOne EMV lenses allows patients to improve visual acuity, reduce IOP and has a positive effect on the anatomical conditions of the eye.