Yonsei Med J.  2015 May;56(3):805-811. 10.3349/ymj.2015.56.3.805.

Intraocular Lens Power Estimation in Combined Phacoemulsification and Pars Plana Vitrectomy in Eyes with Epiretinal Membranes: A Case-Control Study

• Kim M
• Kim HE
• Lee DH
• Koh HJ
• Lee SC
• Kim SS

• KMID: 2450357
• DOI: http://doi.org/10.3349/ymj.2015.56.3.805

Abstract

PURPOSE
To evaluate the accuracy of postoperative refractive outcomes of combined phacovitrectomy for epiretinal membrane (ERM) in comparison to cataract surgery alone.
MATERIALS AND METHODS
Thirty-nine eyes that underwent combined phacovitrectomy with intraocular lens (IOL) implantation for cataract and ERM (combined surgery group) and 39 eyes that received phacoemulsification for cataract (control group) were analyzed, retrospectively. The predicted preoperative refractive aim was compared with the results of postoperative refraction.
RESULTS
In the combined surgery group, refractive prediction error by A-scan and IOLMaster were -0.305+/-0.717 diopters (D) and -0.356+/-0.639 D, respectively, compared to 0.215+/-0.541 and 0.077+/-0.529 in the control group, showing significantly more myopic change compared to the control group (p=0.001 and p=0.002, respectively). Within each group, there was no statistically significant difference in refractive prediction error between A-scan and IOLMaster (all p>0.05). IOL power calculation using adjusted A-scan measurement of axial length based on the macular thickness of the normal contralateral eye still resulted in significant postoperative refractive error (all p<0.05). Postoperative refraction calculated with adjusted axial length based on actual postoperative central foveal thickness change showed the closest value to the actual postoperative achieved refraction (p=0.599).
CONCLUSION
Combined phacovitrectomy for ERM resulted in significantly more myopic shift of postoperative refraction, compared to the cataract surgery alone, for both A-scan and IOLMaster. To improve the accuracy of IOL power estimation in eyes with cataract and ERM, sequential surgery for ERM and cataract may need to be considered.

Keyword

Cataract surgery with vitrectomy; epiretinal membranes; myopic shift; phacovitrectomy; IOL power calculation

MeSH Terms

Aged
Biometry/methods
Case-Control Studies
Cataract Extraction
Epiretinal Membrane/*surgery
Eye
Female
Humans
*Lens Implantation, Intraocular
*Lenses, Intraocular
Male
Optics and Photonics
Phacoemulsification/*methods
Postoperative Period
Refraction, Ocular/physiology
Retrospective Studies
Treatment Outcome
Vision Tests
Visual Acuity
Vitrectomy/*methods

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