Korean J Ophthalmol.  2016 Aug;30(4):280-288. 10.3341/kjo.2016.30.4.280.

Influence of Biometric Variables on Refractive Outcomes after Cataract Surgery in Angle-closure Glaucoma Patients

Affiliations
  • 1Department of Ophthalmology, Chungnam National University Hospital, Daejeon, Korea. kcs61@cnu.ac.kr
  • 2Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Korea.

Abstract

PURPOSE
To evaluate the influence of biometric variables on refractive outcomes after cataract surgery in angle-closure glaucoma (ACG) patients.
METHODS
In this case-control study, 42 ACG patients, 40 open-angle glaucoma (OAG) patients, and 35 controls without glaucoma who had undergone conventional cataract surgery were enrolled consecutively. Electronic medical records, including preoperative biometric variables (keratometric diopter, axial length, anterior chamber depth, and lens thickness), the refractive change (RC), and the absolute value of refractive change (ARC) were reviewed.
RESULTS
In the control and OAG patients, the anterior chamber depth was negatively correlated with the ARC (r = -0.344, p = 0.043 and r = -0.431, p = 0.006, respectively), whereas there was no correlation in the ACG patients. Lens thickness was positively correlated with the RC, but not with the ARC, in the control and OAG groups (r = 0.391, p = 0.020 and r = 0.501, p = 0.001, respectively). In contrast, lens thickness in the ACG group was not correlated with the RC but was positively correlated with the ARC (r = 0.331, p = 0.032).
CONCLUSIONS
In contrast with the anterior chamber depth, preoperatively measured lens thickness may be a useful predictor of the direction of the RC after cataract surgery in control and OAG patients. However, in ACG patients, a thicker lens was correlated with a larger RC, regardless of the direction of the shift (hyperopic or myopic).

Keyword

Absolute value of the refractive change; Angle-closure glaucoma; Anterior chamber depth; Lens thickness; Refractive change

MeSH Terms

Aged
Anterior Chamber/*diagnostic imaging
Biometry/*methods
Female
Follow-Up Studies
Glaucoma, Angle-Closure/*complications/diagnosis/surgery
Glaucoma, Open-Angle/*complications/diagnosis/surgery
Humans
*Intraocular Pressure
Male
Middle Aged
*Phacoemulsification
Refraction, Ocular/*physiology
Retrospective Studies
Tomography, Optical Coherence

Figure

  • Fig. 1 Scattergrams comparing the lens thickness (LT) and anterior chamber depth (ACD) with the refractive change (RC) and absolute refractive change (ARC) in the eyes of normal control subjects and open-angle glaucoma patients who underwent cataract extraction with intraocular lens implantation (n = 75). (A) Correlation between LT and RC (r = 0.428, p < 0.001) and between ACD and RC (r = -0.234, p = 0.039). Multivariate regression analysis formula, RC = 0.198 × ACD + 0.513 × LT - 2.908 (ACD, p = 0.257; LT, p < 0.001). (B) Correlation between LT and ARC (r = 0.264, p = 0.019) and between ACD and ARC (r = -0.394, p < 0.001). Multivariate regression analysis formula, RC = -0.281 × ACD - 0.029 × LT +1.374 (ACD, p = 0.007; LT, p = 0.726). r = correlation coefficient. *Postoperative actual refractive error minus preoperatively predicted refractive error; †Absolute value of refractive change.

  • Fig. 2 Scattergrams comparing the lens thickness (LT) and anterior chamber depth (ACD) with the refractive change (RC) and absolute refractive change (ARC) in patients with angle-closure glaucoma who underwent cataract extraction with intraocular lens implantation (n = 42). (A) Correlation between LT and RC (r = 0.115, p = 0.467) and between ACD and RC (r = -0.034, p = 0.829). (B) Correlation between LT and ARC (β = 0.169, r = 0.331, p = 0.032) and between ACD and ARC (r = -0.175, p = 0.267). r = correlation coefficient; β= regression coefficient. *Postoperative actual refractive error minus preoperatively predicted refractive error; †Absolute value of refractive change.


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