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Pseudophakic anterior chamber depth measurement in second eye refinement cataract surgery

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Session Details

Session Title: Cataract Surgery Outcomes. IOL Power Calculations

Session Date/Time: Monday 07/09/2015 | 16:30-18:30

Paper Time: 16:36

Venue: Room 1

First Author: : P.Gil PORTUGAL

Co Author(s): :    J. Pires   R. Matos   M. Cardoso   J. Matias   M. Mariano        

Abstract Details


To study the effective lens position concept in second eye refinement (SER) cataract surgery, by relating inter-ocular symmetry of pseudophakic anterior chamber depth (pACD) and SER refractive outcomes.


Ophthalmology Department, Centro Hospitalar Baixo Vouga, Portugal.


Retrospective analysis of 88 cases of bilateral consecutive cataract surgery. Prediction errors for the first and second eyes were obtained as the difference between the observed post-operative refraction and the predicted refraction in the intra-ocular lens (IOL) power calculation for 3 formulae (HofferQ,SRK/T and Holladay1). A theoretical partial 50% adjustment of the first eye prediction error was used in the IOL power selection of the second eye. Refractive outcomes were analysed and compared using the mean absolute error (MAE). Pentacam HR was used to measure pACD, and consecutive 50µm increments in inter-ocular asymmetry were used to assess refractive outcomes.


The resulting MAE after the 50% SER was significantly lower in all 3 formulae compared with no adjustment: 0.298D compared with 0.361D (p=0.009) for HofferQ, 0.261D compared with 0.311D (p=0.022) for SRK/T and 0.270D compared with 0.326D (p=0.012) for Holladay1. The pACD was significantly correlated between the first and second eyes (r=0.714; p<0.001). In all 3 formulas, when the inter-ocular difference in pACD was higher than 350µm (11.36% of patients), the MAE resulting from SER was significantly higher and not different when comparing with the no adjustment group.


To our knowledge this is the first study to relate SER outcomes with the measured effective lens position. SER is a valid and promising strategy to improve cataract surgery refractive outcomes in cases of pACD inter-ocular asymmetry up to 350µm.

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