Transcript Visual Outcomes After Implantation of 2 Different

Visual Outcomes After Implantation
of 2 Different Intraocular Lens:
AcrySof SA60AT and MemoryLens
CV232
Sarosh A. Janjua MD1, Sandra L. Cremers MD FACS1
1.
Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA
PURPOSE
To compare the differences in visual
and surgical outcomes after
implantation of AcrySof SA60AT lens
versus MemoryLens CV232 lens.
METHODS
Study Design
Retrospective cohort
Population
A database of 1800 phacoemulsifications performed by
residents at the Massachusetts Eye and Ear Infirmary .
Selection Criteria
Patients were recruited in two groups :
those that were implanted with SA60AT (727 eyes) and those that were
implanted with CV232 (108 eyes)
Exclusion Criteria
Included any co-exitsing ocular pathology
that might affect visual acuity, such as glaucoma, age-related macular
degeneration and previous ocular surgery/trauma.
METHODS
A complete ophthalmological assessment was performed at 1 day, 1 week, 1,
3, 6-9, 12 and 18 months, and the findings were noted.
A number of visual outcomes, including visual acuity in LogMAR units, were
compared between the two groups, as well as surgical outcomes.
Major confounders like history of glaucoma, diabetes, and previous ocular
surgery, as well as the level of experience of the surgeon were controlled
for statistically.
The analysis was performed using STATA Version 9.
RESULTS
There was significantly greater improvement in
best-corrected visual acuity (BCVA) with SA60AT
lens than with CV232 at 3 months (p = 0.04), 6-9
months (p = 0.02), and 12 and 18 months (both p
< 0.001).
The rate of improvement in BCVA was significantly
faster for SA60AT than for CV232 (p < 0.001).
CV232 lens had a greater incidence of both
posterior capsule opacification and YAG
capsulotomy (both p <0.001).
Table 1. Characteristics of the Two Study Groups
SA60AT
CV232
P value
Number of Patients
557
90
Female/Male
314/243
46/44
0.36
Age, years
70.5 ± 12.5
70.6 ± 10.9
0.94
Number of Eyes
OD
OS
Glaucoma
727
356 (49%)
371 (51%)
17 (2.3%)
108
57 (53%)
51 (47%)
11 (10.2%)
<0.001*
Diabetes
146 (20.1%)
30 (27.8%)
0.08
Previous Ocular Surgery
59 (8.1%)
5 (4.6%)
0.25
0.47
Level of Surgeon
Resident
Attending
Outcomes
<0.001*
508 (70%)
219 (30%)
107 (99%)
1 (1%)
PCO noted
217 (29%)
44 (41%)
<0.001*
Median PCO grade
0
1
<0.001*
YAG
14 (1.9%)
14 (13.0%)
<0.001*
AC tear
11 (1.5%)
1 (0.9%)
0.99
PC tear
17 (2.3%)
8 (7.4%)
0.01*†
Vitrectomy
11 (1.5%)
6 (5.6%)
0.02*†
Reoperation
1 (0.1%)
0 (0%)
0.99
*Statistically significant by Fisher’s exact test.
†No significant group differences were found for vitrectomy rates or posterior tears after controlling for level of the surgeon.
Comparison of Visual Acuity After Cataract Surgery between the Two Groups
0.40
Visual Acuity (logMAR units)
SA60AT
CV232
0.30
20/42
20/40
20/38
20/38
20/35
20/35
0.20
20/32
20/30
0.10
20/25
0.00
Baseline 1 day
1 week
1 mo
*
*
*
*
*
3 mo
6 mo
9 mo
12 mo
18 mo
Time Since Surgery
CONCLUSIONS
Patients implanted with SA60AT lens had
greater and faster improvement in bestcorrected visual acuity (BCVA) than those
implanted with CV232 lens.
Incidence of posterior capsule opacification
(PCO) and YAG capsulotomy was higher for
patients implanted with CV232.
FINANCIAL DISCLOSURES
None