TY - JOUR
T1 - The Aravind Pseudoexfoliation Study
T2 - 5-Year Postoperative Results. The Effect of Intraocular Lens Choice and Capsular Tension Rings
AU - Haripriya, Aravind
AU - Ramulu, Pradeep Y.
AU - Schehlein, Emily M.
AU - Shekhar, Madhu
AU - Chandrashekharan, Shivkumar
AU - Narendran, Kalpana
AU - Venkatesh, Rengaraj
AU - Sithiq, Mohammed
AU - Ramakrishnan, Rengappa
AU - Ravindran, Ravilla D.
AU - Robin, Alan L.
N1 - Funding Information:
All authors have completed and submitted the ICMJE form for disclosure of potential conflicts of interest. Funding/Support: Aurolab (Madurai, Tamil Nadu, India) donated capsular tension rings and Alcon Laboratories (Fort Worth, Texas, USA) donated intraocular lenses to those who could not afford them. Neither company had any part in the study design, interpretation of the results, or creation of the manuscript. Financial Disclosures: Dr Robin serves on the board of the Aravind Eye Foundation, is the Executive Vice President of the American Glaucoma Society, and is a consultant to Perfuse Therapeutics and Versant Health Care. The other authors indicate no financial conflict of interest. All authors attest that they meet the current ICMJE criteria for authorship.
Publisher Copyright:
© 2020 Elsevier Inc.
PY - 2020/11
Y1 - 2020/11
N2 - Purpose: We compared rates of intraocular lens (IOL) decentration, neodymium-doped yttrium aluminum garnet capsulotomy for posterior capsule opacification (PCO), and visual acuity (VA) in eyes with and without pseudoexfoliation (PEX) 5 years after undergoing cataract surgery. Design: Prospective comparative interventional study. Methods: This multicenter study population included 1 eye of both 930 cataract patients with and 470 cataract patients without uncomplicated PEX (no small pupils or phacodonesis) all undergoing phacoemulsification by experienced Aravind Eye Care System surgeons. Eyes were randomized to either 1- or 3-piece intraocular lenses (IOLs). PEX eyes were also randomized to either receive or not receive a capsule tension ring. The main outcome measures included IOL decentration and PCO. Secondary outcomes included postoperative best-corrected VA. Results: Follow-up was 86.2% in the PEX group and 86.7% in the control group at 5 years. The PEX group was older (P <.001) and had more men (P =.01). IOL decentration at 5 years was equally prevalent in PEX and control eyes (1.0% vs 1.1%, respectively, P =.8). Neodymium-doped yttrium aluminum garnet posterior capsulotomy rates for PCO were similar in the PEX group when compared with control subejcts (5.3% compared with 3.2%, respectively, P =.07). Best corrected VA was better at baseline and years 2 and 3 in the control group (P =.0001, P =.0005, and P =.02); however, there was no difference in BCVA at years 1, 4, and 5 between the PEX and control groups (P =.09, P =.29, and P =.5). Conclusion: In a large-scale, long-term, prospective comparative study of cataract surgery in eyes with uncomplicated PEX, the risks of IOL decentration and PCO were low and comparable to that in control subjects. When approaching cataract surgery in eyes with relatively uncomplicated PEX, neither IOL choice (1- vs 3-piece acrylic IOL) nor the presence/absence of a capsule tension ring affects outcomes at 5 years.
AB - Purpose: We compared rates of intraocular lens (IOL) decentration, neodymium-doped yttrium aluminum garnet capsulotomy for posterior capsule opacification (PCO), and visual acuity (VA) in eyes with and without pseudoexfoliation (PEX) 5 years after undergoing cataract surgery. Design: Prospective comparative interventional study. Methods: This multicenter study population included 1 eye of both 930 cataract patients with and 470 cataract patients without uncomplicated PEX (no small pupils or phacodonesis) all undergoing phacoemulsification by experienced Aravind Eye Care System surgeons. Eyes were randomized to either 1- or 3-piece intraocular lenses (IOLs). PEX eyes were also randomized to either receive or not receive a capsule tension ring. The main outcome measures included IOL decentration and PCO. Secondary outcomes included postoperative best-corrected VA. Results: Follow-up was 86.2% in the PEX group and 86.7% in the control group at 5 years. The PEX group was older (P <.001) and had more men (P =.01). IOL decentration at 5 years was equally prevalent in PEX and control eyes (1.0% vs 1.1%, respectively, P =.8). Neodymium-doped yttrium aluminum garnet posterior capsulotomy rates for PCO were similar in the PEX group when compared with control subejcts (5.3% compared with 3.2%, respectively, P =.07). Best corrected VA was better at baseline and years 2 and 3 in the control group (P =.0001, P =.0005, and P =.02); however, there was no difference in BCVA at years 1, 4, and 5 between the PEX and control groups (P =.09, P =.29, and P =.5). Conclusion: In a large-scale, long-term, prospective comparative study of cataract surgery in eyes with uncomplicated PEX, the risks of IOL decentration and PCO were low and comparable to that in control subjects. When approaching cataract surgery in eyes with relatively uncomplicated PEX, neither IOL choice (1- vs 3-piece acrylic IOL) nor the presence/absence of a capsule tension ring affects outcomes at 5 years.
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U2 - 10.1016/j.ajo.2020.06.031
DO - 10.1016/j.ajo.2020.06.031
M3 - Article
C2 - 32621898
AN - SCOPUS:85090411659
SN - 0002-9394
VL - 219
SP - 253
EP - 260
JO - American journal of ophthalmology
JF - American journal of ophthalmology
ER -