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First Author: U.De Sanctis ITALY
Co Author(s): E. Bartoli L. Vinai F. Grignolo
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To assess the predictability of postoperative refractive error after cataract surgery combined with Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) using different keratometric (K) values for intraocular lens (IOL) power calculation.
Department of Surgical Sciences, Ophthalmology Institute, University of Turin, Italy.
One eye of 33 consecutive patients with Fuchs dystrophy and cataract, who had undergone phacoemulsification, posterior chamber IOL (Acrysof SN60AT, Alcon, USA) implantation and DSAEK, was included. In each eye, the acquired manifest refraction was measured 6 months after surgery. The predicted refraction was calculated retrospectively, using 5 different keratometric values in the IOL power calculation formula: real, and reduced by -0.50, -1.00, -1.50 and -2.00 diopters (D). The mean absolute difference (mean absolute prediction error (MAE)) between acquired and predicted refraction obtained using different K values was calculated and compared.
Mean MAE values were 0.85ḟ0.57D, 0.62ḟ0.51D, 0.57ḟ0.43D, 0.66ḟ0.45D and 0.83 ḟ0.60D, repectively, when the K value used for IOL power calculation was real, reduced by -0.50, -1.00, -1.50 and by -2.00 D. MAE achieved by reducing the K value by -0.50/-1/-1.50D was significantly lower than with the real K value or that reduced by -2 D. The percentage of eyes in which acquired vs. predicted refraction difference was within ḟ0.50/ḟ1D was 36%/70% for real K, 51.5%/70% for K reduced by -0.50D, 54.6%/84.9% for K reduced by -1.00D, 45.5%/82% for K reduced by -1.50D, and 27.3%/66.7% for K reduced by - 2.00D.
Postoperative refractive error after cataract surgery combined with DSAEK is highly predictable provided that the K value used for IOL power calculation is reduced. The predictability is similar if the K value is reduced by values in the range -0.50 to -1.5 D.