Refractive lensectomy outcomes and complications for myopia and hyperopia: A 15-year retrospective study

Abstract

Purpose: To investigate the type and rate of ophthalmic complications that may occur following refractive lensectomies.Methods: This is a retrospective consecutive case series exploring the incidence of complications in 437 eyes that received refractive lensectomies by a single surgeon from 1993 to 2000. All participants had a clear crystalline lens and a best-corrected visual acuity (BCVA) of 20/40 or better prior to the lens exchange. Main outcome measures included uncorrected visual acuity (UCVA) and BCVA after clear lensectomy, the rate of posterior capsular fibrosis formation, and retinal complications such as retinal detachments (RD) and cystoid macular edema (CME).Results: Following the refractive lensectomy, all subjects experienced an improvement in UCVA and BCVA as compared to pre-operative levels (p<0.05). During the greater than 15-year follow-up period, 36% of subjects experienced posterior capsule opacification (PCO) requiring a Neodymium-doped ytrium aluminum garnet laser (Nd:YAG) capsulotomy, 0.23% experienced retinal detachments, and 0.46% experienced cystoid macular edema. The overall rate of retinal complications following refractive lensectomy was 0.69%. All patients with complications were treated appropriately with good outcomes.Conclusion: This series demonstrated excellent visual acuity outcomes following refractive lensectomy. Although studies suggest that refractive lensectomy leads to high rates of retinal complications and detachments, with modern surgery it can be a safe option for patients seeking refractive surgery. Careful and continuous follow-up is essential.Brief Summary Statement: In this retrospective case series, the incidence of ocular complications was assessed in 437 eyes that have undergone refractive lensectomies with up to 15 years of follow up. Our results show that refractive lensectomies have a superior efficacy and safety profile, with a 0.69% overall rate of retinal complications, including retinal detachments and cystoid macular edema.