Clinical profile and inventory gaps for extreme power intraocular lens implantation

Purpose: The purpose of the study was to evaluate visual outcomes in eyes implanted with extreme power intraocular lenses (IOLs) and to assess the impact of institutional inventory gaps on surgical wait time. Materials and Methods: A retrospective observational study was conducted at a secondary eye care center in Sambalpur, Odisha. IOL powers from 7948 cataract surgeries performed between March 2024 and March 2025 were analyzed to establish an institution-specific definition. Powers <+10 D and >+30 D (±2 standard deviation of institutional mean) were classified as extreme. A total of 104 eyes met the inclusion criteria. Results: Mean best-corrected visual acuity improved significantly from 1.61 ± 0.46 to 0.43 ± 0.25 logMAR ( P < 0.001), with 75.3% of eyes achieving ≥6/18 vision. Eyes requiring high-power IOLs (>+30 D) had a significantly longer mean surgical wait time (14.92 ± 7.04 days) compared to low-power eyes (<+10 D; 11.05 ± 8.59 days; P = 0.0279). Cataract grade did not significantly influence wait time ( P = 0.7492). Conclusion: Extreme power IOL implantation results in significant visual improvement comparable to standard cases. However, high-power IOLs are associated with longer surgical wait times due to inventory gaps. Data-driven stocking strategies are recommended to improve workflow efficiency.