Patients willing to consider elective lens exchange surgery can rest a little easier knowing the decision isn’t likely to lead to adverse events. A recent study found a low occurrence of adverse events or major visual acuity loss following the procedure. The large cohort investigation found the most common problem after surgery was posterior capsular opacification at just 4%. Macular issues were the other most common cause of vision loss.

The retrospective case series included 18,689 eyes that underwent refractive lens exchange in private refractive surgery clinics over a two-year period. The investigators calculated the loss of two or more lines of corrected distance visual acuity for the patients who had at least a three-month follow-up.

The researchers noted most eyes, 84.3%, had a multifocal IOL while the other 15.7% received a monofocal IOL. Post surgery, the study found a total of 1,164 adverse events (6% incidence), with 171 deemed serious and potentially sight threatening (an incidence of 0.9%). Posterior capsular opacification occurred in 748 eyes.

The study also reported the loss of two or more lines of corrected distance visual acuity in 0.56% of eyes when excluding those for whom the loss was due to posterior capsular opacification. The investigators noted the majority of these cases were due to macular causes.