Refractive Surgery/Vision Correction

Predicting Pseudophakic Refractive Error

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What is the best way to predict pseudophakic refractive error in patients who are about to undergo cataract surgery? Investigators recently sought the answer by conducting a prospective case series involving 100 individuals. 

Investigators calculated optimum intraocular lens (IOL) power and predicted refractive outcomes using the Barrett Universal II, Hill-RBF, and SRK/T formulas.  They then compared the predicted refraction with objective refractive outcomes 1 week, 1 month, and 3 months after surgery. Among the results: 

  • Average axial length was 23.4 mm, and mean keratometry was 43.9 diopters. 
  • Average prediction errors at 3 months were 0.50, 0.49, and 0.52 D, respectively. 
  • Universal II served as a better predictor than the others at 1 week.
  • All methods performed similarly at 1 and 3 months. 
  • RBF predicted the highest proportion of eyes within ±0.25 D at 3 months. 
  • Keratometric changes primarily occurred 1 to 4 weeks postop.
  • A significant hyperopic shift was seen 4 to 12 weeks postop. 

Wallace H, Misra S, Li S, McKelvie J. Predicting pseudophakic refractive error: Interplay of biometry prediction error, anterior chamber depth, and changes in corneal curvature.  [Published online ahead of print August 2, 2018]. J Cataract Refract Surg. doi:  https://doi.org/10.1016/j.jcrs.2018.06.017

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