Intraocular Lens Power Estimation in Combined Phacoemulsification and Pars Plana Vitrectomy in Eyes with Epiretinal Membranes: A Case-Control Study.
10.3349/ymj.2015.56.3.805
- Author:
Min KIM
1
;
Hyoung Eun KIM
;
Dong Hyun LEE
;
Hyoung Jun KOH
;
Sung Chul LEE
;
Sung Soo KIM
Author Information
1. Department of Ophthalmology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Korea.
- Publication Type:Original Article ; Evaluation Studies ; Research Support, Non-U.S. Gov't
- Keywords:
Cataract surgery with vitrectomy;
epiretinal membranes;
myopic shift;
phacovitrectomy;
IOL power calculation
- MeSH:
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
- From:Yonsei Medical Journal
2015;56(3):805-811
- CountryRepublic of Korea
- Language:English
-
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.
