Refractive Outcomes after Primary Vitrectomy Combined with Cataract Surgery

Abstract

Purpose: To evaluate the tendency of refractive prediction error and to examine factors that affect the refractive changes after combined vitrectomy and cataract surgery. Methods: We retrospectively reviewed demographic and clinical data, including axial length, intraocular pressure (IOP), preoperative anterior chamber depth, target refraction, preoperative refraction, postoperative refraction, keratometry, and refractive prediction error (the difference between postoperative and target refraction) of a retinal detachment (RD) group (28 eyes) and an epiretinal membrane (ERM) group (82 eyes). Both groups underwent combined vitrectomy and cataract surgery. Results: The refractive prediction error with myopic shift was evident in total patients (-0.85 ± 0.85 D, p < 0.001), the RD group (-0.92 ± 1.13 D, p = 0.007), and the ERM group (-0.83 ± 0.78 D, p < 0.001). There was no significant difference between preoperative and postoperative keratometry in the two groups (p = 0.742 and 0.500, respectively). The preoperative IOP of the affected eye was significantly lower than that of the unaffected eye in the RD group (p = 0.012). In multivariate regression analysis, preoperative axial length was significantly correlated with the refractive prediction error in both the RD (β = 0.189, p = 0.036) and ERM (β = 0.689, p < 0.001) groups. Age, IOP, and preoperative visual acuity were not significantly associated with the refractive prediction error. Conclusions: A significant myopic shift was observed in the RD and ERM groups after combined vitrectomy and cataract surgery with gas tamponade. The preoperative axial length was significantly correlated with the refractive prediction error in both groups.

Assessment of Risk Factors Affecting Refractive Outcomes after Phacovitrectomy for Epiretinal Membrane

“…Another strength of this study is the fact that we examined PE using three different formulae (SRK/T, Haigis, and SRK II) rather than using only one formula as in other previous studies [11][12][13][14][15][16]. We also analyzed PE at different timepoints of 1, 3, and 6 months post-operatively to identify any time-related changes.…”

“…It is cost-effective, reduces the number of necessary surgeries and improves intraoperative macula visualization by removing the opacified lens [4]. However, previous studies have reported that combined phacovitrectomy for ERM may result in myopic shift of the target postoperative refraction [10][11][12][13][14], but few studies were able to identify factors associated with such myopic shift [15,16].…”

“…It is cost-effective, reduces the number of necessary surgeries and improves intraoperative macula visualization by removing the opacified lens [ 4 ]. However, previous studies have reported that combined phacovitrectomy for ERM may result in myopic shift of the target postoperative refraction [ 10 – 14 ], but few studies were able to identify factors associated with such myopic shift [ 15 , 16 ]. Thus, the purpose of this study is to evaluate postoperative refractive outcome accuracy after combined phacovitrectomy for ERM and determine risk factors affecting refractive outcomes.…”

Refractive Outcomes of Intraocular Lenses with Different Haptic Designs Following Phacovitrectomy with Gas Tamponade

“…공수정체가 앞으로 밀리면서 발생하는 것으로 보인다. [7][8][9][10][11][12] 백내장수술 단독 시행 시 인공수정체의 지지부 형태에 따 른 안정성을 비교한 연구가 있으며, 13,14 Xiao et al 13…”