Difference Between Postoperative Refraction and Predictive Refraction after Cataract Operation in Patients with Coexisting Cataract and Primary Angle-closure Glaucoma

Kim, Sun A; Kang, Jae Hoon; Park, Jong Il; Lee, Kyung Hun

Abstract

PURPOSE
To report the difference between the postoperative spherical equivalent (SE) and predictive refraction in patients with cataract and primary angle-closure glaucoma (PACG) following cataract operation. METHODS: (1) This study involved 60 eyes who underwent cataract surgery due to PACG and cataract, and 36 eyes who underwent surgery due to cataract only. We measured the manifest refraction postoperatively for comparision to the target power. (2) The axial length (AL) was measured by the different modes of A-scans(phakic, aphackic modes) in the 38 eyes with cataract. (3) The difference was calculated according to the three IOL power calculation formulas for the 60 eyes who had cataract surgery for coexisting PACG and cataract. RESULTS: The difference between postoperative SE and predictive refraction was -0.61+/-0.91D in the PACG with cataract and +0.08+/-0.43D in eyes with cataract only. There was no difference according to the IOL power calculation formulas or the different modes observed in the measurement of AL. A greater difference was seen in eyes with a short AL and an unmeasurable ACD. CONCLUSIONS: The difference between postoperative SE and predictive refraction increased in eyes with the PACG and cataract over those with cataract only. For cataract operation in these eyes, the choice of a lower power IOL (about 0.5D) may be helpful to reduce this difference, especially for eyes with a short AL (less than 24 mm) and an unmeasurable ACD.