Comparison of postoperative refractive outcome in eyes undergoing combined phacovitrectomy vs cataract surgery following vitrectomy
To investigate the accuracy of preoperative biometry in eyes undergoing combined phacovitrectomy and to compare it with eyes having cataract surgery at a later point in time following vitrectomy.
Patients with epiretinal membrane or macular hole who underwent combined phacovitrectomy (group 1) or phacoemulsification following pars plana vitrectomy (PPV) (group 2) were included in this retrospective, comparative, interventional case series. The primary outcome measures were the intraocular lens power prediction error (PE) and the percentage of eyes with PE > ± 0.5D in the two groups. Secondary outcome measures included the correlation between epidemiological, clinical, or surgical factors and dioptric shift. In addition, the influence of optical coherence tomography characteristics to the PE was investigated.
Group 1 and 2 consisted of 55 and 54 eyes, respectively, for a total of 109 eyes included in the study. The mean absolute PE was 0.59 D (range + 1.4 to − 2.5D) in group 1 and 0.35 (range + 1.0 to − 1.45D) in group 2 (p = 0.01). PE greater than 0.5D was observed in 47% of eyes in group 1 as opposed to 16.6% of eyes in group 2 (p = 0.027). The PE was associated with shallower anterior chamber depth (ACD), increased central macular thickness (> 300 μ), and worse baseline best-corrected visual acuity. Photoreceptor ellipsoid zone or external limiting membrane disruption was not associated with significantly greater postoperative refractive deviations.
Combined phacovitrectomy may result in greater postoperative refractive prediction error compared to phacoemulsification alone following vitrectomy. Patients with worse vision, greater central macular thickness, and shallow anterior chambers require more caution since they are prone to inaccurate preoperative biometry.
KeywordsPhacovitrectomy Vitrectomy Refractive error Prediction error Epiretinal membrane Macular hole
Compliance with ethical standards
Conflict of interest
All authors declare that they have no conflict of interest.
All procedures performed involving human participants were in accordance with the ethical standards of the Ophthalmica Eye Institute and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 19.Kucumen RB, Yenerel NM, Gorgun E, Kulacoglu DN, Dinc UA, Alimgil ML (2008) Anterior segment optical coherence tomography measurement of anterior chamber depth and angle changes after phacoemulsification and intraocular lens implantation. J Cataract Refract Surg 34:1694–1698PubMedCrossRefPubMedCentralGoogle Scholar
- 28.Shams N, Mobaraki H, Kamali M, Jafarzadehpour E (2015) Comparison of quality of life between myopic patients with spectacles and contact lenses, and patients who have undergone refractive surgery. J CurrOphthalmol 27(1-2):32–36Google Scholar
- 37.Patel D, Rahman R, Kumarasamy M (2007) Accuracy of intraocular lens power estimation in eyes having phacovitrectomy for macular holes. J CataractRefractSurg 33:1760–1762Google Scholar
- 44.Devgan U (2004) Which IOL formula should be used for which eyes. https://www.healio.com/ophthalmology/cataract-surgery/news/print/ocular-surgery-news/%7Bbf57b195-d532-46da-95f4-c2019665237f%7D/which-iol-formula-should-be-used-for-which-eyes. Accessed 20 Nov 2017