Simultaneous Pterygium and Cataract Removal with Light Adjustable Lens Implantation

Purpose: This study aims to report the refractive and visual outcomes of pseudophakic eyes that underwent simultaneous pterygium and cataract surgery with Light Adjustable Lens (LAL) implantation. This combined approach serves as an alternative to the traditional two-stage surgery, addressing logistical and financial concerns for patients requiring both procedures. Methods: This retrospective analysis included pseudophakic eyes that received simultaneous pterygium removal, cataract extraction, and LAL implantation between May 2021 and August 2024. Surgical procedures encompassed precise LAL calculations, pterygium excision, and cataract removal followed by LAL placement. Postoperative care included medications and custom LAL adjustments using the Light Delivery Device (LDD) to fine-tune refractive outcomes. Visual acuity, manifest refraction, and corneal astigmatism were recorded preoperatively, postoperatively before the first LAL adjustment, and again three months after surgery. Results: The study included 18 eyes from 14 patients. Three months post-surgery, refractive outcomes improved significantly, with a mean spherical equivalent (SEQ) of -0.29 D (±0.29). Half of the eyes achieved an SEQ of less than 0.25 D, and 83% achieved less than 0.5 D. Mean uncorrected distance visual acuity (UCDVA) improved to LogMAR 0.096 (±0.11). Refractive astigmatism also decreased notably, underscoring the effectiveness of the simultaneous procedure with LAL in attaining favorable visual outcomes. Conclusions: Simultaneous pterygium and cataract surgery with LAL implantation provides excellent refractive and visual outcomes, offering a viable alternative to staged surgery. Postoperative LAL adjustments help counteract corneal unpredictability associated with pterygium, making it a feasible choice for patients with financial or logistical challenges. Further research with larger sample sizes and extended follow-up periods is suggested to confirm these results.