J Korean Ophthalmol Soc.  2015 Feb;56(2):219-227. 10.3341/jkos.2015.56.2.219.

Accuracy of Predictive Refraction in Combined Vitrectomy-Cataract Surgery for Epiretinal Membrane and Macular Hole

• Lim HC
• Kim KH
• Shin MK
• Park SW
• Byon IS
• Lee JE

• KMID: 2216005
• DOI: http://doi.org/10.3341/jkos.2015.56.2.219

Abstract

PURPOSE
To evaluate the accuracy of predictive refraction and the factors influencing the predictability in combined vitrectomy and cataract surgery.
METHODS
We retrospectively investigated patients who received combined vitrectomy and cataract surgery for idiopathic epiretinal membrane (ERM) and macular hole (MH), followed up for a minimum of 6 months. Preoperative refraction, target refraction, postoperative refraction, predictive refraction error (target refraction - postoperative refraction), accuracy of predictive refraction error (predictive refraction error was within +/-0.5 diopter), intraocular pressure, axial length, central macular thickness, and tools that were used for intraocular lens power calculation (A-scan and IOL master) were assessed by analyzing medical records.
RESULTS
A total of 176 eyes (including 132 idiopathic ERM cases and 44 MH cases) were included in this study. The accuracy of predictive refraction error was 60.8% at 6 months and there was no difference between the idiopathic epiretinal membrane group (59.8%) and the macular hole group (63.6%). There was no significant difference in predictive refraction error according to axial length and tools (IOL master vs A-scan). Predictive refraction error correlated positively with preoperative refraction (r = 0.227; p = 0.002). In the ERM group, predictive refraction error correlated negatively with both preoperative central macular thickness and the change in central macular thickness between, before, and 6 months after surgery (r = -0.211; p = 0.015 and r = -0.241; p = 0.005).
CONCLUSIONS
The accuracy of predictive refraction error was approximately 60% in combined vitrectomy and cataract surgery. Postoperative refraction appeared to be myopia relative to target refraction with higher preoperative myopia and thicker preoperative central macular thickness. Hence, the intraocular lens power should be determined considering the above factors.

Keyword

Accuracy of predictive refraction; Combined vitrectomy and cataract surgery; Predictive refraction error; Refractive error

MeSH Terms

Cataract
Epiretinal Membrane*
Humans
Intraocular Pressure
Lenses, Intraocular
Medical Records
Myopia
Refractive Errors
Retinal Perforations*
Retrospective Studies
Vitrectomy

Figure

• 

  Figure 1. Correlation between axial length and predictive refraction error. There was a weak negative correlation 3 months (A) (r = -0.153, p = 0.042) and 6 months after surgery (B) (r = -0.148, p = 0.05).

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  Figure 2. Correlation between preoperative refraction and predictive refraction error. There was a positive correlation at 3 months (r = 0.208, p = 0.006) (A) and 6 months (r = 0.227, p = 0.002) (B).

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  Figure 3. Correlation between preoperative central macular thickness and predictive refraction error. There were negative correlations between preoperative central macular thickness and predictive refraction error (r = -0.212; p = 0.015 and r = -0.211; p = 0.015).

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  Figure 4. Correlation between change of central macular thickness and predictive refraction error. There were negative correlations between change of central macular thickness and predictive refraction error (r = -0.222; p = 0.01 and r = -0.241; p = 0.005) at 3 (A) and 6 (B) months.

Reference

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