First Eye Prediction Error Improves Second Eye Refractive Outcome Results in 2129 Patients after Bilateral Sequential Cataract Surgery


Aristodemou, P; Cartwright, NEK; Sparrow, JM; Johnston, RL; (2011) First Eye Prediction Error Improves Second Eye Refractive Outcome Results in 2129 Patients after Bilateral Sequential Cataract Surgery. Ophthalmology, 118 (9). pp. 1701-1709. ISSN 0161-6420 DOI: https://doi.org/10.1016/j.ophtha.2011.05.010

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Abstract

Objective: To define theoretical correction factors for second-eye intraocular lens (IOL) power adjustment based on first eye refractive prediction error (PE). Design: Database study. Participants: We included 2129 patients who underwent bilateral sequential phacoemulsification cataract surgery with the same IOL model. Methods: Retrospectively calculated PEs (Hoffer Q, Holladay 1, SRK/T) were analyzed for association between paired eyes, examining the effect of interocular differences in axial length (AL) and corneal power. A range of correction factors (CF) derived from the first eye PE were applied to the second eye PE using optimized and non-optimized IOL constants (IOLCs). Main Outcome Measures: Second eye mean absolute error (MAE). Results: Prediction errors of paired eyes were correlated. Interocular corneal power differences exceeding 0.60 diopters (D) were associated with a weaker correlation but interocular AL differences did not affect the correlation. When a 50% CF was applied to second eyes of patients with a first eye PE between +/-0.50 and +/-1.50 D, it improved refractive outcomes from 30%, 56%, and 92% to 42%, 75%, and 96% within +/-0.25 D, +/-0.50 D and +/-1.00 D, respectively, and reduced the MAE from 0.49 to 0.37 D (P < 0.0001). For first eye PE below +/-0.50 D, a 50% CF reduced the MAE from 0.32 to 0.30 D (P < 0.00001). A 50% CF also reduces second eye MAE for eyes with nonoptimized IOLCs. Conclusions: A 50% CF reduces second eye PE when either first eye optimized PE is within +/-1.50 D or when nonoptimized IOLCs are used. The correlation is weaker when interocular corneal power differences are >0.60 D.

Item Type: Article
Keywords: intraocular-lens power, partial coherence interferometry, cataract-surgery, hoffer-q, biometry, formula, srk/t
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
PubMed ID: 21762991
Web of Science ID: 294479200003
URI: http://researchonline.lshtm.ac.uk/id/eprint/61589

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