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Predictability of refraction following immediate sequential bilateral cataract extraction (ISBCE)

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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: 17:58

Venue: Room 1

First Author: : L.Remont BELGIUM

Co Author(s): :    I. Guber   C. Bergin                 

Abstract Details


To evaluate the predictability of refraction following immediate sequential bilateral cataract extraction (ISBCE).


Kantonsspital Winterthur, Winterthur, Switzerland


This is a retrospective review of all ISBCE surgeries performed at Kantonsspital Winterthur, Switzerland, between April 2000 and September 2013. The case notes of 250 patients were reviewed. Those patients having full refraction reported were included in this study, these were 110 patients/220 eyes: 210 (95%) eyes had a straight forward phacoemulsification with posterior chamber intraocular lens implantation, seven eyes had a planned extracapsular cataract extraction, three eyes had an intracapsular cataract extraction.


Eyes of 110 patients with a mean age of 79.0 years, SD ±11.4 were included. Median preoperative BCVA was 0.5 LogMAR in the first eye, the interquartile range was [0.4, 1.2], in the second eye 0.7 LogMAR with the IQR [0.4, 1.8]. At one month the median BCVA was 0.2 LogMAR, IQR [0.1, 0.3] in the first eye, median BCVA was 0.1 LogMAR IQR [0.0, 0.5]. There were 3 eyes (3%) which had lost 3 lines or more in BCVA at one month control as compared to preoperatively, in all three cases, poor visual acuity had been recorded pre-operatively (>1 logMAR). Achieved refraction was within 1D of the target in 83% of study eyes.


ISBCE achieves target refraction in 83% of eyes. When complications, ocular co-morbidities and systemic restriction were considered, there were only 5% of cases where if delayed sequential bilateral extraction had been performed could IOL choice potentially been adjusted, in 4 of these cases target refraction was within 1D in the second eye, suggesting that such a correction would not be beneficial in the majority of cases. This further supports the proposition that ISBCE is an effective and safe option.

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