J Korean Ophthalmol Soc.  2023 Nov;64(11):1022-1029. 10.3341/jkos.2023.64.11.1022.

Predictive Accuracy of Refraction after Transscleral Fixation of Intraocular Lenses in Trabeculectomized Eyes with Glaucoma

• Kim DS
• Park BH
• Kwon HJ
• Park SW
• Byon IS

• KMID: 2547865
• DOI: http://doi.org/10.3341/jkos.2023.64.11.1022

Abstract

Purpose
To investigate the predictive accuracy of refraction and any change in intraocular pressure (IOP) after transscleral fixation of intraocular lenses (IOLs) in trabeculectomized eyes with glaucoma.
Methods
We retrospectively reviewed the medical records of glaucoma patients who underwent trabeculectomy, followed by transscleral fixation of dislocated IOLs combined with vitrectomy. The refraction predicted by the SRK/T formula and the postoperative refraction were converted into spherical equivalents. Predictive refraction accuracies were analyzed when the differences between the two values were within ± 0.5 diopters (D) and ± 1.0 D. The IOP was measured before and after surgery.
Results
Eleven eyes of 11 men (mean age, 67.27 ± 10.55 years) were included. The mean axial length was 23.64 ± 1.26 mm; the mean predicted and postoperative refractions were -0.02 ± 0.46 D and -0.80 ± 0.98 D, respectively (p = 0.029). The refractive outcome was more myopic (by -0.78 ± 1.11 D) than predicted. The predictive accuracies were 36.4% and 72.7% when the differences were ± 0.5 and ± 1.0 D, respectively. The IOP did not change during follow-up (13.18 ± 4.56, 12.82 ± 5.88, and 12.73 ± 4.58 mmHg at baseline, 1 week, and 3 months, respectively).
Conclusions
In trabeculectomized eyes, transscleral IOL fixation did not affect the IOP, but the refractive outcome was more myopic than predicted. This difference should be considered when choosing IOL target power.

Keyword

Dislocation of intraocular lens, Predictive accuracy of refraction, Refractive error, Trabeculectomy, Transscleral fixation