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Can improved genetic risk assessment for age-related macular degeneration assist IOL selection for cataract and refractive lens surgery?

Session Details

Session Title: Surgical Outcomes

Session Date/Time: Monday 07/10/2013 | 08:00-09:30

Paper Time: 08:24

Venue: Auditorium (First Floor)

First Author: : S.Arshinoff CANADA

Co Author(s): :    B. Zanke              

Abstract Details

Purpose:

To evaluate progress in genetic risk assessment for macular degeneration (AMD) and its potential importance for IOL selection in cataract surgery and refractive lens exchange.

Setting:

York Finch Eye Associates, Toronto, Canada

Methods:

Choice in IOLs continues to grow post cataract surgery with increasing demand by enlightened patients for "enhanced function" IOLs. Multifocal IOLs have been shown to reduce contrast sensitivity. AMD also reduces contrast sensitivity, and the combination of even mild AMD and multifocal IOLs may synergistically further reduce contrast sensitivity. Genetic risk of AMD is fundamentally a disorder of repair, and as more factors are identified, prediction accuracy now approaches 90%. We have been using an AMD genetic predictive tool in consenting patients, to screen patients who want to consider multifocal IOL implantation.

Results:

Cataract patients who wanted to consider multifocal IOLs were offered genetic assessment. Risk scores were stratified into 5 groups, and each patient’s results were discussed with them and their families. All lens choices were made in conjunction with the patient after discussion of the results. Sometimes the genetic result did not match our pre-testing phenotypic impression, and we considered these cases particularly valuable.

Conclusions:

Patients at high genetic risk for AMD were discouraged from considering multifocal IOLs. Genetic testing for AMD risk has recently been improved and further improvements are expected. This should prove to be a useful tool to assist IOL selection in cataract and refractive lens surgery.

Financial Interest:

... is employed by a for-monetary company with an interest in the subject of the presentation