Partial Blink Rate As A Biomarker For Refractive Prediction Error After Cataract Surgery

To evaluate the impact of partial blink behavior on prediction error (PE) after cataract surgery and determine whether partial blink rate (PBR) serves as a biomarker for refractive outcomes.

Single-center retrospective study, Chungnam National University Hospital, Daejeon, Korea 

23 eyes that underwent cataract surgery with monofocal intraocular lenses were retrospectively evaluated. Preoperative tear film interferometry was assessed using LipiView. PE was quantified as mean absolute error (MAE1–MAE4) using the absolute difference between PE and achieved spherical equivalent. MAE1–4 were calculated using the Barrett Universal II, SRK/T, Hoffer Q, and Haigis formulas, respectively. Logistic regression, Correlation between Partial blink rate (PBR, %) and MAE were analyzed statistically.

Partial blink rate was significantly correlated with refractive prediction error for all MAE metrics (MAE1: r=0.55, p=0.006; MAE2: r=0.61, p=0.002; MAE3: r=0.50, p=0.015; MAE4: r=0.50, p=0.014). Logistic regression demonstrated that higher PBR increased the odds of MAE >0.50D (MAE1 OR 1.05, p=0.008; MAE2 OR 1.03, p=0.023; MAE3 OR 1.03, p=0.035; MAE4 OR 1.03, p=0.046). These results showed that elevated PBR served as a predictor of postoperative refractive prediction error, with higher PBR increasing the likelihood of MAE >0.50D.

Partial blink behavior is significantly associated with prediction error after cataract surgery. Elevated PBR may increase the risk of refractive prediction error by inducing tear film instability and keratometric variability. Incorporating blink metrics into preoperative evaluation may help optimize refractive outcomes.