J Korean Ophthalmol Soc.  2009 Jul;50(7):1022-1026. 10.3341/jkos.2009.50.7.1022.

Postoperative Refractive Error by Using A-scan in Cataract Surgery After Vitrectomy

• Kang S
• Chung SK

• KMID: 2212489
• DOI: http://doi.org/10.3341/jkos.2009.50.7.1022

Abstract

PURPOSE
To investigate the difference between target refraction and actual refraction of intraocular lens implantation when cataract surgery was performed after vitrectomy. METHODS: This study evaluated 28 eyes of 28 patients who had undergone vitrectomy without gas tamponade and 25 eyes of 25 patients who had undergone vitrectomy with gas tamponade. A-scans were performed before the respective cataract and vitrectomy surgeries. Three months after cataract surgery, the actual refraction was measured. To compare the difference between the actual and the target refraction calculated by each A-scan, the refractive prediction error was calculated. It is determined by subtracting the target refraction from the actual refraction. RESULTS: In 28 eyes, the mean refractive prediction error calculated by the A-scan performed before vitrectomy was -0.146+/- 0.901D (diopter, D), and the mean refractive prediction error calculated by an A-scan performed just prior to cataract surgery was -0.228+/-1.011D. The two values were not statistically significant (p=0.653). In 25 eyes, the mean refractive prediction errors calculated by A-scans performed before vitrectomy and cataract surgery were -0.171+/-1.079D, and -0.227+/-0.798D, respectively. There was no statistically significant difference between the two values (p=0.563). CONCLUSIONS: When a cataract surgery was performed after vitrectomy, a precise target refraction could be obtained.

Keyword

A-scan; Cataract surgery; Refraction; Refractive prediction error; Vitrectomy

MeSH Terms

Cataract
Eye
Humans
Lens Implantation, Intraocular
Refractive Errors
Vitrectomy

Reference

References

1. Shioya M, Ogino N, Shinjo U. Change in postoperative refractive error when vitrectomy is added to intraocular lens implantation. J Cataract Refract Surg. 1997; 23:1217–20.

2. Kovacs I, Ferencz M, Nemes J, et al. Intraocular lens power calculation for combined cataract surgery, vitrectomy and peeling of epiretinal membranes for macular oedema. Acta Ophthalmol Scand. 2007; 85:88–91.

3. Falkner-Radler CI, Benesch T, Binder S. Accuracy of preoperative biometry in vitrectomy combined with cataract surgery for patients with epiretinal membranes and macular holes: results of a prospective controlled clinical trial. J Cataract Refract Surg. 2008; 34:1754–60.

4. Kim DH, Kim Sk, Koh HJ, Kwon OW. Postoperative refractive error in combined operation of vitrectomy and intraocular lens implantation. J Korean Ophthalmol Soc. 2002; 43:1644–8.

5. Jeoung JW, Chung H, Yu HG. Factors influencing refractive outcomes after combined phacoemulsification and pars plana vitrectomy: results of a prospective study. J Cataract Refract Surg. 2007; 33:108–14.

6. Lee DK, Lee SJ, You YS. Prediction of refractive error in combined vitrectomy and cataract surgery with one-piece acrylic intraocular lens. Korean J Ophthalmol. 2008; 22:214–9.

7. Hotta K. Postoperative refractive error of secondary intraocular lens implantation after simultaneous vitrectomy and lensectomy. Ophthalmic Surg Lasers Imaging. 2007; 38:336–8.

8. Scharwey K, Pavlovic S, Jacobi KW. Combined clear corneal phacoemulsification, vitreoretinal surgery and intraocular lens implantation. J Cataract Refract Surg. 1999; 25:693–8.

9. Koenig SB, Han DP, Mieler WF, et al. Combined phacoemulsification and pars plana vitrectomy. Arch Ophthalmol. 1990; 108:362–4.

10. Demetriades AM, Gottsch JD, Thomsen R, et al. Combined phacoemulsification, intraocular lens implantation, and vitrectomy for eyes with coexisting cataract and vitreoretinal pathology. Am J Ophthalmol. 2003; 135:291–6.

11. Suzuki Y, Sakuraba T, Mizutani H, et al. Postoperative refractive error after simultaneous vitrectomy and cataract surgery. Ophthalmic Surg Lasers Imaging. 2000; 31:271–5.

12. Nishigaki S, Kida Y, Uchida H, et al. Refractive changes after triple procedure for diabetic macular edema. Jpn J Clin Ophthalmol. 1998; 52:1135–37.

13. Schweitzer KD, Garcia R. Myopic shift after combined phacoemulsification and vitrectomy with gas tamponade. Can J Ophthalmol. 2008; 43:581–3.