J Korean Ophthalmol Soc.  2019 May;60(5):447-454. 10.3341/jkos.2019.60.5.447.

Refractory Outcomes after Cataract Surgery in Acute Primary Angle-closure Glaucoma Patients Treated with Laser Iridotomy

• Hwang HS
• Kim DY
• Kim HT
• Chae JB
• Hyung S

• KMID: 2445138
• DOI: http://doi.org/10.3341/jkos.2019.60.5.447

Abstract

PURPOSE
To analyze the accuracy of ocular biometry and prediction of postoperative refraction after cataract surgery in acute primary angle-closure glaucoma (ACG) patients treated with laser iridotomy (LI).
METHODS
We retrospectively reviewed the medical records of 44 patients who underwent cataract surgery after LI due to ACG (ACG group), and 37 patients who underwent cataract surgery without ocular disease other than cataract (control group) from January 2015 to May 2018. An Acrysof® single piece (SN60WF) was used as the intraocular lens. We performed preoperative ocular biometry and intraocular lens power calculations using AL-Scan®. The accuracy of the postoperative refractive power prediction was analyzed according to the anterior chamber depth (ACD) and axial length (AL).
RESULTS
The preoperative ACD was 2.29 ± 0.32 mm in the ACG group and 3.15 ± 0.27 mm in the control group (p < 0.01), and the respective AL values were 22.53 ± 0.80 mm and 23.87 ± 1.38 mm (p < 0.01). Using the Haigis formula, patients with an ACD < 2.30 mm in the ACG group (0.52 ± 0.36 diopters [D]) had less accurate results in terms of the mean absolute error than patients with an ACD > 2.31 mm in the ACG group (0.27 ± 0.20 D) and control group (0.27 ± 0.20 D). There was no significant difference in the mean absoluter error between each formula in patients with an AL of < 22.0 mm or > 22.1 mm in the ACG and control groups.
CONCLUSIONS
Among patients treated with LI due to ACG, those patients with an ACD > 2.31 mm showed no difference in refractory prediction compared to the control group. However, in patients with an ACD < 2.30 mm, the refractory prediction may be inaccurate when using the Haigis formula, a fourth-generation formula that takes into account the ACD.

Keyword

AL-Scan®; Angle-closure glaucoma; Anterior chamber; Axial length; Refractive errors

MeSH Terms

Anterior Chamber
Biometry
Cataract*
Glaucoma, Angle-Closure*
Humans
Lenses, Intraocular
Medical Records
Refractive Errors
Retrospective Studies

Figure

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  Figure 1. Comparison of various IOL power calculation formulas according to anterior chamber depth. Stacked histogram compare the percentage of eyes within a given diopter range of predicted spherical equivalent refraction outcome. A-C indicated group A, group B, and control group individually. IOL = intraocular lens; D=diopter.

Reference

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