Simultaneous pterygium and cataract removal with light adjustable lens implantation

Purpose: To evaluate the refractive and visual outcomes of pseudophakic eyes undergoing simultaneous pterygium and cataract surgery with light adjustable lens (LAL) implantation, offering a single-stage alternative to the traditional 2-stage approach. Setting: Clinical practice setting in Tijuana, Baja California, Mexico. Design: Retrospective, observational study. Methods: Eyes that underwent simultaneous pterygium and cataract removal with LAL implantation between May 2021 and August 2024 were included. The surgical protocol involved LAL calculation, pterygium excision, cataract extraction, and LAL implantation. Postoperative care included medication and refractive adjustments using the light delivery device to achieve desired refractive outcomes. Visual acuity, manifest refraction, and corneal astigmatism were assessed preoperatively, before the first LAL adjustment, and 3 months postoperatively. Results: 18 eyes from 14 patients were analyzed. Mean spherical equivalent (SEQ) improved to −0.29 diopter (D) (±0.29) at 3 months. 9 eyes (50%) achieved SEQ <0.25 D, and 15 eyes (83%) achieved SEQ <0.5 D. Mean uncorrected distance visual acuity improved to logMAR 0.096 (±0.11). Refractive astigmatism was significantly reduced, demonstrating the procedure's effectiveness in achieving favorable visual and refractive outcomes. Conclusions: Simultaneous pterygium and cataract surgery with LAL implantation offers a viable alternative for patients who face logistical challenges with the traditional 2-stage approach. The adjustability of the LAL mitigates refractive unpredictability caused by corneal irregularities. Further studies with larger sample size and longer follow-up are required to support these findings.