The Journal of Practical Medicine >

2025 , Vol. 41 >Issue 4: 536 - 542

DOI: https://doi.org/10.3969/j.issn.1006-5725.2025.04.011

Clinical Research

Efficacy and safety of clear lens extraction with extended depth of focus intraocular lens implantation in the treatment of primary angle⁃closure suspect with presbyopia

  • Jianwen PENG ,
  • Wei CHEN ,
  • Lan HUANG ,
  • Zhiqi CHEN ,
  • Sifei XIANG ,
  • Xianlin ZHANG ,
  • Junming. WANG
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  • Department of Ophthalmology，Renhe Hospital affiliated to China Three Gorges University，Yichang 443000，Hubei，China

Received date: 2024-11-08

  Online published: 2025-02-28

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Abstract

Objective To assess the efficacy of clear lens extraction combined with extended depth of focus （EDOF） intraocular lens （IOL） implantation in enhancing visual quality and concurrently opening peripheral angle structures in patients diagnosed with primary angle closure suspect （PACS） and presbyopia. Methods A total of 80 patients with PACS， presbyopia， and transparent lenses were enrolled and divided into two groups based on the type of implanted lens： a control group （n = 46） and an experimental group （n = 34）. The control group underwent clear lens extraction followed by monofocal intraocular lens implantation， while the experimental group underwent clear lens extraction followed by extended depth of focus （EDOF） intraocular lens implantation. Preoperative and postoperative evaluations at 3 months included visual acuity， intraocular pressure， anterior segment structure， defocus curve， and Catquest 9SF?CN questionnaire scores. Adverse events were recorded to assess safety. Results Regarding the angular structure， after 3 months of treatment， results indicated significant increases in central anterior chamber depth， angle opening distance at 750 μm， angle recess area at 750 μm， trabecular?iris space area at 750 μm， and trabecular?iris angle at 750 μm in both groups compared to preoperative values （all P < 0.01）. However， no significant differences were observed between the two groups （all P > 0.05）. For the defocusing curve， visual acuity in the experimental group improved from +1.0 D to -4.0 D after 3 months of treatment （all P < 0.05）， while the control group showed improvements at +0.5 D， -0.5 D， -1.0 D， -2.0 D， -3.0 D， -3.5 D， and -4.0 D （all P < 0.05）. Postoperatively at 3 months， the experimental group exhibited superior visual acuity to the control group at -1.0 D to -4.0 D （all P < 0.05）. According to the Catquest 9SF?CN scale， scores in both groups significantly improved after 3 months of treatment （P < 0.01）， with the experimental group scoring higher than the control group （P < 0.01）. During the study， transient intraocular pressure elevation occurred in 7 patients （3 in the control group and 4 in the experimental group）， but no serious adverse reactions were reported in either group. Conclusions In patients with pseudoexfoliation glaucoma combined with presbyopia， significant improvements in angle structures were observed following clear lens extraction. The implantation of an EDOF IOL notably enhanced postoperative visual quality compared to monofocal IOLs.

Key words： clear lens extraction; extended depth of focus intraocular lens; primary angle closure suspect; presbyopia; visual quality

Cite this article

Jianwen PENG , Wei CHEN , Lan HUANG , Zhiqi CHEN , Sifei XIANG , Xianlin ZHANG , Junming. WANG . Efficacy and safety of clear lens extraction with extended depth of focus intraocular lens implantation in the treatment of primary angle⁃closure suspect with presbyopia[J]. The Journal of Practical Medicine, 2025 , 41(4) : 536 -542 . DOI: 10.3969/j.issn.1006-5725.2025.04.011

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