Compared with trifocal group, the uncorrected intermediate VA (UIVA) [MD = 0.09, 95 % CI: 0.01 to 0.17) was significantly worse in the bifocal group. The device is not intended for use on patients who have had previous trauma to their eye. Cataract removal surgery is considered not medically necessary for the Patients with monofocal IOLs had more frequently recommended near addition (74 %) than those with multi-focal IOLs. Last, the studies included used different types of bifocal and trifocal IOLs; therefore, the pooled effect might not be accurate enough. Clinical Practice Guideline no. Rahti et al (2020b) stated that IC antibiotic in cataract surgery has shown level I evidence as prophylaxis for post-operative endophthalmitis. The difference was statistically significant (p = 0.003). Evidence of a superior effect of hydrophobic acrylic lenses over silicone lenses, specifically for posterior synechiae outcomes comes from a single study at a high risk of performance and detection bias. Links to various non-Aetna sites are provided for your convenience only. Adelaide, Australia: Adelaide Health Technology Assessment (AHTA) on behalf of National Horizon Scanning Unit (HealthPACT and MSAC); 2004. Do DV, Gichuhi S, Vedula SS, Hawkins BS. They stated that further research is needed to improve the understanding of how accommodative IOLs may affect near visual function, and whether they provide any durable gains. 2001;67(2):196-198. They last searched the electronic databases on October 10, 2013. 2017;65(9):813-817. The funding source was disclosed by investigators of the largest study (professional society) and not reported by the other 3. Another drawback was only 121 patients out of 289 patients had recorded anterior chamber lengths in chart review. However, there may be some out-of-pocket costs associated with the procedure, such as the deductible, Baltimore, MD: CMS; May 3, 2005. A total of 295 eyes were reviewed, 61 had only pre-operative IOLMaster measurements and 234 had both IOLMaster and ORA measurements. The studies were at low risk of selection bias, but 2 of the 4 studies did not employ masking and only 1 study included all randomized participants in the final analyses. 2013;120(5):942-948. CrystaLens, U.S. Food and Drug Administration (FDA), Center for Devices and Radiologic Health (CDRH). J Cataract Refract Surg. Topical antibiotic was not prescribed to 17,855 (42 %) eyes -- 5723 (32 %) eyes in ICC group and 12,132 (68 %) eyes in ICM group. These researchers included RCTs and quasi-randomized trials of eyes affected by both cataract and ARMD in which cataract surgery would be compared to no surgery. Treating providers are solely responsible for medical advice and treatment of members. WebThe response from physicians to Aetnas prior authorization requirement for cataract surgery was overwhelming, and it strengthened efforts to influence the insurer to change its decision. Multiple optic (multi-focal) IOLs are available which claim to allow good vision at a range of distances. They last searched the electronic databases on October 3, 2014. Some patients may experience visual halos, glare or starbursts. Haigis W, Lege B, Miller N, et al. list-style-type : square !important; They included 4 RCTs, including 229 participants (256 eyes), conducted in Germany, Italy and the UK. 2003;48(6):594-612. Monofocal IOLs have a fixed focal length and provide clear vision at a single, distance (near, intermediate or far) only. They also noted that whether that improvement outweighed the adverse effects of multi-focal IOLs, such as glare and haloes, would vary between people; and motivation to achieve spectacle independence was likely to be the deciding factor. They searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register) (2017, Issue 5), Medline Ovid (1946 to May 17, 2017), Embase.com (1947 to May 17, 2017), PubMed (1946 to May 17, 2017), Latin American and Caribbean Health Sciences Literature database (LILACS) (January 1982 to May 17, 2017), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com); last searched May 2013, ClinicalTrials.gov (www.clinicaltrials.gov); searched May 17, 2017, and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en); searched May 17, 2017. The refractive outcome was analyzed using the mean absolute error (MAE; difference between predicted and achieved post-operative spherical equivalent refraction), and multi-variable regression analysis was performed to compare the 2 groups. Available at: http://emedicine.medscape.com/article/1228865-overview#aw2aab6b3. They graded 2 studies with high risk of detection bias and 1 study with high risk of selection bias. These researchers judged all studies to be at high risk of performance bias. None of the included studies reported quality of life outcomes. N Engl J Med. The post-operative refraction of bifocal group was similar to that of trifocal group (MD = -0.08, 95 % CI: - 0.19 to 0.03 for spherical equivalent; MD = -0.09, 95 % CI: - 0.21 to 0.03 for cylinder; MD = -0.09, 95 % CI: - 0.27 to 0.08 for sphere). Ultrasound, with intra-ocular lens (IOL) power calculation. Vitrectomy timing for retained lens fragments after surgery for age-related cataracts: A systematic review and meta-analysis. Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites. This test is used to measure and record the evaluation of corneal endothelial cells. Cochrane Database Syst Rev. Refractive outcomes of intraoperative wavefront aberrometry versus optical biometry alone for intraocular lens power calculation. In complicated cataract surgeries, CTR implantation appeared to improve clinical outcomes. The images are then computed to give the local slope and character of the wavefront of light. In all bilateral implantation cases, the same model IOL was used in each eye. A total of 150 patients received the AcrySof Natural IOL and 147 patients received the AcrySof single-piece IOL as a control. list-style-type: upper-alpha; .newText { Moreover, these researchers stated that in order to achieve more significant findings, RCTs with larger sample size are needed. Rana K, Bahrami B, van Zyl L, et al. padding-bottom: 4px; With modern optical biometry for the majority of patients, informed formula choice and IOL constant optimization outcomes of more than 90 % within 1 D and more than 60 % within 0.5 D of target are achievable. Effect of intraocular lens size on posterior capsule opacification after phaecoemulsification. 2014;28(2):118-125. In a retrospectivestudy, Zhang et al (2017) compared the outcomes of intra-operative wavefront aberrometry (e.g., optiwave refractive analysis (ORA)) versus optical biometry alone for intra-ocular lens (IOL) power calculation in eyes undergoing cataract surgery with mono-focal IOL implantation. Cataract in the adult eye. Ophthalmologe. Health Care Financing Administration. The RR of developing endophthalmitis was 2.94 (95 % CI: 1.07 to 8.12; p = 0.037) in eyes that did not receive IC antibiotics. There is some evidence that distance visual acuity with accommodative lenses may be worse after 12 months but due to low quality of evidence and heterogeneity of effect, the evidence for this is not clear-cut. ul.ur li{ The authors concluded that femtosecond laser could perform a capsulotomy with high reliability. Fogla R, Rao SK. For members with visual disability with a Snellen Acuity of 20/40 or better, cataract surgery is considered medically necessary when all of the following subjective, objective, and educational criteria are met: The member perceives that his or her ability to carry out needed or desired activities is impaired. U.S. Department of Health and Human Services. Rai et al (2015) noted that surgery in the presence of zonular weakness or subluxated lens was a great surgical challenge and included intra-capsular cataract extraction with anterior chamber IOL implantation or pars plana lensectomy and vitrectomy with a sutured IOL. Immersion A-scan compared with partial coherence interferometry: Outcomes analysis. 2011;(7):CD004242. Accommodative intraocular lenses for age-related cataracts. American Academy of Ophthalmology. The mean follow-up time was 84 months for all of the IOL groups. Retina. Both unilateral and bilateral implantation trials were included. An IOL is used to improve vision after the native lens is removed by helping to focus light directly onto the retina. Two review authors independently screened the search results according to the standard methodological procedures expected by Cochrane. 2005;31(12):2319-2323. Malyugin B, Anisimova N, Antonova O, Arbisser LB. the member's own assessment of visual disability (e.g., impact on driving, viewing television, and special occupational or avocational needs) and, in particular, disability at near sight (e.g., reading, occupational activities requiring near vision); and. Posterior capsular opacification in 1 eye (2.4 %), anterior capsule phimosis in 1 eye (2.4 %) and cystoid macular edema (CME) in 1 eye (2.4 %) were detected as late complications. This difference was possibly due to a more precise capsulorrhexis, resulting in a more stable IOL position. Posterior capsule opacification is a common complication after cataract surgery. These researchers identified a second potentially relevant study of immediate versus delayed cataract surgery in 54 people with ARMD. You can also call our customer service number at 1-800-123-4567 for more information about Patients were randomized to receive either the 1CU accommodative IOL in their first eye or the Acrysof MA30 monofocal IOL. Cataract Surgery Comprehensive Ophthalmology Lenses Lifestyle Lenses Implantable Collamer Lens (ICL) Vivity Extended Vision IOL Keratoconus Treatments Cross-Linking INTACS Corneal Implants Oculoplastic Cosmetic Treatments Cosmetic Treatments Blepharoplasty Dry Eye Treatments Dry Eye Treatments TearCare Glaucoma Surgery 4, Cataract in Adults: Management of Functional Impairment of the Cataract Management Guideline Panel of the Agency for Health Care Policy and Research (AHCPR, 1993). The cases were divided into 4 groups -- group 1 included the first 50 cases, group 2 included cases 51 through 100, group 3 included cases 101 through 150, and group 4 included cases 151 through 200 -- and were analyzed. The studies summarized in this review should assist recommendations for the standard of care of cataract surgery, at least in developed settings. } Zhang (2018) reported a case of significant hyperopic outcome (both eyes) following ORA IOL power recommendation in a cataract patient with history of 8 cut radial keratotomy (RK) in each eye. #backTop:hover { Complications were reported at 12 months (2 studies), 12 to 18 months (1 study), and 2 years (4 studies) after surgery. Eye (Lond). Comparison of visual acuity between phacoemulsification and extracapsular cataract extraction: A systematic review and meta-analysis. Rarely, a cataract may form within months when related to trauma, inflammation or use of some medications. 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