ASCRS 2023: Using IOL to alter choroidal thickness after cataract surgery

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Erisa Yotsukura, MD, PhD, from the Department of Ophthalmology, Keio University School of Medicine, Tokyo, and colleagues evaluated an intraocular lens (IOL) that transmits violet light and an IOL that did not. This difference they believe can affect the differences in the choroidal thickness after cataract surgery.

The researchers evaluated 402 patients (402 eyes) who were to undergo cataract surgery.

The patients were followed for 1 year after the surgery and had been randomized to implantation withZCB00V IOL (Johnson & Johnson) (group Z, 202 cases; mean age, 68.2 years), which does not transmit violet light. or the W-60R IOL (Santen Pharmaceutical) (group W, 200 cases; mean age, 69.1 years), which transmits violet light partially. The subfoveal choroidal thickness was measured before and 3, 6, 9, and 12 months postoperatively; the changes in the choroidal thicknesses were compared and analyzed between the 2 groups from 3 to 12 months postoperatively.

The lenses differed in that the ZCB00V IOL did not transmit violet light and the W-60R IOL does partially.

The investigators measured the subfoveal choroidal thickness before surgery and then at follow-up visits at 3, 6, 9, and 12 months after surgery and then compared the differences between the 2 groups.

Differences in the IOLs

Preoperatively, there were no significant difference between the 2 IOLs in the logarithm of the minimum angle of resolution best-corrected visual acuity (logMAR BCVA) and the corneal refractions.

The differences in the noncycloplegic objective refractions, the axial lengths and the choroidal thicknesses in the Z and W groups reached significance; they were, respectively, -3.97 and -2.19 diopters (p<0.01), 24.89 and 24.13 mm (p<0.001), and 213.0 and 236.2 μm (p=0.01).

Postoperatively, from 3 to 12 months, the mean changes in the logMAR BCVAs, noncycloplegic objective refractions, corneal refractions and axial lengths did not reach significance.

However, the changes in the choroidal thicknesses during the same time period postoperatively did reach significance. They were, respectively, -1.79 and 3.48 μm (p=0.01).

The investigators concluded, “The IOL that transmits different wavelengths of light during cataract surgery may cause a difference in the postoperative change in the choroidal thickness.”