Axial Elongation And Iol Power Calculation Implications Following Combined Ppv And Encircling Scleral Band Surgery

To evaluate postoperative changes in axial length (AL) and ocular biometry following combined pars plana vitrectomy (PPV) and encircling scleral band surgery for retinal detachment (RD), with a focus on factors influencing AL progression. While prior research has examined biometric changes after scleral buckle procedures, this study is the first to investigate AL elongation and associated ocular biometric alterations following combined PPV and encircling scleral band surgery.

This study was conducted at a large tertiary referral hospital 

A retrospective study of patients who underwent combined PPV and encircling scleral band surgery at a tertiary center between 2018 and 2024. Preoperative and postoperative biometric measurements included AL, anterior chamber depth (ACD), lens thickness (LT), keratometry, intraocular pressure (IOP), white-to-white (WTW) best-corrected visual acuity (BCVA). Predicted intraocular lens (IOL) power was assessed using Barrett Universal II, Haigis, SRK/T, Hoffer Q, Barrett True-K, and Haigis-L formulas.

Data from 45 eyes (mean age 55.7 ± 11.2 years) was analyzed; mean preoperative BCVA was 0.88 ± 0.85 LogMAR, 20 eyes (44.4%) were Mac-On. A significant postoperative AL increase was observed (25.65 ± 1.66 mm vs. 26.21 ± 1.70 mm; p < 0.001) along with LT reduction (4.36 ± 0.62 mm vs. 3.89 ± 1.36 mm; p = 0.029). Mac-On and Mac-Off groups showed significant AL elongation after macular status stratification (p < 0.001). AL elongation was significantly greater in operated compared to fellow eyes (p = 0.001). Age, IOP, and lens status did not significantly affect AL change.

Postoperative biometric changes significantly reduced predicted IOL power: Barrett Universal II (-1.95D), Haigis (-2.12D), SRK/T (-2.24D), and Hoffer Q (-2.42D) (all p < 0.001).

This study demonstrates a significant increase in AL and alterations in ocular biometry following combined PPV and encircling scleral band surgery, with corresponding reductions in IOL power predictions. These findings underscore the importance of performing updated preoperative biometric assessments before cataract surgery in these patients. Given the magnitude of AL changes, postoperative IOL calculations may be impacted. Further research is warranted to explore the long-term effects of postoperative AL elongation and biometric shifts on refractive stability and visual outcomes.