Ocular Biometry Results After Cataract Surgery In Very Elderly Patients Over 90 Years

Cataracts are the leading cause of vision loss in the elderly and several studies have reported that cataract surgery in very elderly patients is safe and effective. Refractive prediction error (PE) is one of the most common postoperative complication of cataract extraction and intraocular (IOL) implantation surgery. The objective of this study was to report the characteristics of patients receiving cataract surgery among age groups and to evaluate the ocular biometry results, prediction errors and visual acuity improvement according to age in cataract surgery.

Retrospective, single-center study with 817 patients who underwent cataract surgery from March 2014 to June 2021. Ocular biometric results were obtained via IOL Master 700® along with demographics, comorbidities, medical records, operation data. Age group was categorized by decade age at operation date (Group 1: over 90, Group 2: 80-89, Group 3: 70-79, Group 4: 60-69, Group 5: Under 59).

Absolute Prediction Error (PE), K average value (Km), Axial Length (AL), Anterior Chamber Depth (ACD), Lens thickness (LT) and other continuous variables were compared among age groups by analysis of variance (ANOVA) with Bonferroni’s adjustment. Categorical variables were compared among age groups using Fisher’s exact test. Simple correlations between age and variables including absolute PE, Km, AL, ACD, LT were examined using the Pearson’s correlation analysis. To identify the independent predictors of absolute PE, LT, and ACD, multiple linear regression analysis was performed.

Age group 1 (over 90 years old) experienced higher general anesthesia rate. The prevalence of hypertension, cerebral vessel diseases, age-related macular degeneration and pseudoexfoliation was higher in the older age groups. Axial length, anterior chamber depth, lens thickness was statistically significant with age. VA improvement measured by -logMAR was the highest in the age group 1. Absolute prediction errors showed no statistically significant results among age groups. Age had statistically significant correlation with absolute PE, Km, AL, ACD and LT using the Pearson’s correlation analysis. Age had statistically significant effect on LT, but not on absolute PE and ACD using multiple regression analysis.

Axial length was shorter and anterior chamber depth was shallower in older age groups with statistical significance. Lens thickness was thicker in older age with statistical significance and have statistically significant correlation with age. Absolute prediction errors measured by Haigis, SRK/T, HofferQ, Barrett formulae showed no statistically significant results among age groups. Lens thickness was found to be affected by age according to multiple linear regression analysis.