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First Author: S.Ehlers Klug DENMARK
Co Author(s): P. Jeppesen T. Olsen
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To investigate if there is a difference in the quality of calculations of expected postoperative refraction prior to cataract surgery in a group of patients with PEX compared to a control-group of patients of equal sex and age but without PEX.
PEX is an age-related generalized condition. It is mainly expressed in the anterior segment of the eye, where an abnormally, fibrillary substance can be found. PEX leads to reduced quality of the zonular apparatus and zonular threads, which may increase axial movement of the capsule after implantation of an intraocular lens and consequently induce a higher variation of the postoperative refraction.
Retrospective case-control study from database material. An examination and a control group each consisting of twenty-two persons was identified. All the patients in the examination group had PEX at the time of preoperative examination and all had their cataract surgery in the interval from the February 4. 2008 to the August 31. 2009. The examination group was matched with patients who had no other diagnosis than cataract. The patients in the control-group were of equal sex, age and had similar axial length (AL). The control-patients had their cataract surgery from 1998 to 2008. The preoperative data also included anterior chamber depth (ACD), best visual acuity with optimal correction and spherical equivalent. Postoperative data included measurement of visual acuity with optimal correction and thereby spherical equivalent. The estimation of the expected postoperative spherical equivalent was calculated using the Olsen Formula. AL and ACD were measured using the Tomey AL-100, Japan.
Preoperative ACD in the examination group ranged from 2.31 to 3.75 mm with a mean at 3.03 mm and a standard deviation of 0.36 mm. In the control-group from 2.00 to 4.03 mm with a mean at 3.08 mm and a standard deviation of 0.58 mm. The study showed no statistically difference in the preoperative ACD, p >0.05. The postoperative spherical equivalent in the examination group ranged from -1.75 to +1.25 D, with a mean value of -0.48 D and had a standard deviation of 0.73 D. The postoperative spherical equivalent in the control-group ranged from -1.25 to +2.00 D with a mean value of -0.11 D and a standard deviation of 0.72 D. The study showed no statistically difference in the postoperative spherical equivalent, p >0.05.
The study showed no significant difference in the predicted and the actual postoperative refraction in patients with PEX compared to other patients surgery. The calculation of IOL power in patients with PEX can be performed without special considerations since the reliability and quality of the preoperative refractive calculation is equal for patients with PEX compared to other patients.