J Korean Ophthalmol Soc.  2010 Feb;51(2):195-202. 10.3341/jkos.2010.51.2.195.

Effects of Anterior Chamber Depth and Axial Length on Refractive Error after Intraocular Lens Implantation

• Maeng HS
• Ryu EH
• Chung TY
• Chung ES

• KMID: 2213140
• DOI: http://doi.org/10.3341/jkos.2010.51.2.195

Abstract

PURPOSE
To investigate the error tendency between preoperative expected refraction and postoperative manifest refraction based on anterior chamber depth (ACD) and axial length (AXL) in cataract surgery cases and to report how ACD and AXL affect determination of intraocular lens (IOL) power.
METHODS
We retrospectively studied 82 eyes of 62 patients who underwent cataract surgery in our hospital between August 2008 and January 2009. Anterior chamber depth and AXL were measured using IOL Master(R), and IOL power was calculated using the SRK II and SRK/T formulae. Patients were divided into three groups based on ACD and into another three based on AXL. Refractive error (RE) was analyzed one month after surgery.
RESULTS
Though the RE of each group showed a tendency for hyperopic shifts, only those obtained with the SRK/T formula showed statistically significant differences between groups (p<0.05). Using the SRK/T formula, we found that an increasing AXL was associated with an increased hyperopic shift. This was more pronounced in those with shallow ACD (<2.5 mm), though the difference was not statistically significant. Similarly, an increase in ACD was associated with an increased hyperopic shift, and this difference was more pronounced in those with short AXL (<22.5 mm), and this time the difference was statistically significant.
CONCLUSIONS
As ACD and AXL significantly affect RE, both should be considered when investigating postoperative RE tendency and when determining IOL power. Postoperative RE will be greatly affected by a short AXL or a shallow ACD, and therefore these factors should be considered in IOL power determination.

Keyword

Anterior chamber depth; Axial length; Refractive error

MeSH Terms

Anterior Chamber
Cataract
Eye
Humans
Lens Implantation, Intraocular
Lenses, Intraocular
Refractive Errors
Retrospective Studies

Figure

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  Figure 1. Relationship between refractive error, axial length and anterior chamber depth. Note that the refractive error change increases more in shallow anterior chamber group but not statistically significant.

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  Figure 2. Relationship between refractive error, anterior chamber depth and axial length. Note that the refractive error change was statistically significant in short axial length group (p=0.00).

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  Figure 3. The postoperative change of depth of anterior chamber in shallow anterior chamber eye. The intraocular lens can be implanted in a more anterior or posterior plane than pre-operatively planned in short or long axis eye respectively. a=postoperative anterior chamber depth; b=predicted value of postoperative anterior chamber depth.

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  Figure 4. Large refractive change can be caused more in short axis than in long axis eyes.

Reference

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