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|Issue 144||May 2018|
The report is a product of the VA/HSR&D Evidence Synthesis Program.
Comparing Effectiveness of Intraocular Lenses for Cataract Surgery and Lens Replacement
Cataract is an eye condition in which the natural crystalline lens becomes cloudy and can ultimately lead to poor vision. Usually associated with aging, cataract affects more than 24.4 million Americans age 40 and older, and it is estimated that half of all Americans older than age 75 have cataract or have had cataract surgery. Surgical removal of cataract and the implantation of a prosthetic lens is one of the most common surgeries performed in the United States.
Monofocal intraocular lenses have been the "gold standard" for cataract surgery and lens replacement. However, the most commonly used type of advanced intraocular lens implant in the U.S. is the multifocal lens, which is now FDA approved and produces multiple focal points at far and near distances. Another alternative is accommodating intraocular lens implants which can provide a depth of focus rather than distinct focal points. Additional lens designs are available internationally and are currently under development in the U.S.. While there are potential advantages to these advanced lenses, there also may be disadvantages including unwanted visual symptoms (i.e., glare and halo). Moreover, many pre-existing ocular conditions are considered contraindications to their use.
This systematic review was requested to assess the benefits and harms of these types of intraocular lens implants so that further guidance on their use within VA can be provided. Investigators with VA's Evidence-based Synthesis Program (ESP) Center in West Los Angeles, CA searched PubMed from 1/1/2006 to 4/30/2017 to identify literature that would offer insight into the comparative effectiveness of multifocal, accommodative, and monofocal intraocular lenses for cataract surgery and lens replacement. After identifying 760 potentially relevant citations, of which 93 abstracts were reviewed as full-text publications, 12 were used in this review.
Summary of Findings
**A cyberseminar session titled "Comparative Effectiveness of Multifocal, Accommodative, and Monofocal Intraocular Lenses for Cataract Surgery and Lens Replacement" will be held on Wednesday, June 13, 2018 from 3:00pm to 4:00pm (ET).. Register for this session.**
View the full report — **VA Intranet only**:
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ESP is currently soliciting review topics from the broader VA community. Nominations will be accepted electronically using the online Topic Submission Form. If your topic is selected for a synthesis, you will be contacted by an ESP Center to refine the questions and determine a timeline for the report.
This Management e-Brief is provided to inform you about recent HSR&D findings that may be of interest. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs. If you have any questions or comments about this Brief, please email CIDER. The Center for Information Dissemination and Education Resources (CIDER) is a VA HSR&D Resource Center charged with disseminating important HSR&D findings and information to policy makers, managers, clinicians, and researchers working to improve the health and care of Veterans.
This report is a product of VA/HSR&D's Quality Enhancement Research Initiative's (QUERI) Evidence-Based Synthesis Program (ESP), which was established to provide timely and accurate synthesis of targeted healthcare topics of particular importance to VA managers and policymakers –; and to disseminate these reports throughout VA.
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