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Visual and refractive outcomes and glistenings occurrence after implantation of 2 monofocal, aspheric, hydrophobic acrylic IOLs

Stanojcic, N., O'Brart, D., Hull, C. ORCID: 0000-0002-2205-4443 , Wagh, V., Azan, E., Bhogal, M., Robbie, S. & Olivia Li, J-P. (2020). Visual and refractive outcomes and glistenings occurrence after implantation of 2 monofocal, aspheric, hydrophobic acrylic IOLs. Journal of Cataract and Refractive Surgery, 46(7), pp. 986-994. doi: 10.1097/j.jcrs.0000000000000201


PURPOSE: To compare the Clareon intraocular lens (IOL) with the Tecnis PCB00 IOL in terms of visual performance, refractive outcomes, glistenings occurrence, and quality-of-life outcomes.

SETTING: Guy's and St Thomas' NHS Foundation Trust, London, England.

DESIGN: Single-center, single-masked, prospective, randomized, controlled trial.

METHODS: One hundred thirty-nine patients with bilateral cataracts were randomized to receive the Clareon (C IOL) or Tecnis (T IOL) IOL. Visual acuity, refraction, central corneal thickness (CCT), endothelial cell loss, contrast sensitivity, and mesopic gap acuity, evaluation of glistenings and rates of perioperative and postoperative complications were recorded. Quality-of-life outcomes were measured with the EuroQOL-5 Dimension questionnaire and the Patient-Reported Outcome Measures questionnaire. Optimised A-constants were available for the T IOL but not the C IOL.

RESULTS: Seventy-one patients (140 eyes) received the C IOL and 68 patients (134 eyes) received the T IOLs. Data were analysed for the first implanted eye. At 12 months, mean uncorrected distance visual acuity (logarithm of the minimum angle of resolution) was 0.02+/-0.10 and 0.01+/-0.08 (mean+/- SD; P=0.49; 95% CI -0.02, 0.04) in the C IOL and T IOL groups, respectively. Corrected visual acuity was -0.02+/-0.09 and -0.03+/-0.06, respectively (P=0.45; 95% CI -0.02, 0.04). The increase in CCT was 14+/-19 and 16+/-28 μm, respectively (P=0.63;95% CI -10.16, 6.16). Mean absolute refraction spherical equivalent error from target refraction was 0.41+/-0.28 for the C IOL and 0.25+/-0.2 for the T IOL groups (P=0.002; 95% CI 0.08, 0.24). Glistenings were minimal (median grade 0), with no difference in grades between groups (P=0.2). PROMS improved postoperatively and were similar in both groups.

CONCLUSIONS: There were no differences in visual outcomes between the Clareon IOL and Tecnis PCB00 IOLs. Glistenings were rarely observed in either IOL with no difference in grades. There was no difference in perioperative or postoperative complications. Surgeon optimization of the A-constant for the Clareon IOL is recommended.

Publication Type: Article
Additional Information: © 2020. This manuscript version is made available under the CC-BY-NC-ND 4.0 license
Publisher Keywords: Cataracts, Intraocular lenses, Glistenings
Subjects: R Medicine > RE Ophthalmology
Departments: School of Health & Psychological Sciences
Text - Accepted Version
Available under License Creative Commons Attribution Non-commercial No Derivatives.

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