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Refractive changes after phacoemulsification in patients with corneal edema
First Author: C. Briceno-Lopez SPAIN
Co Author(s): M. Díez-Ajenjo N. Burguera-Giménez M. García-Domene M. Luque C. Peris-Martínez
To assess refractive changes in patients with corneal edema one month after cataract surgery, in order to know the optimal moment to prescribe optical compensation.
1. FISABIO-Medical Ophthalmology. Valencia. Spain 2. Optics, Optometry and Visual Sciences department. University of Valencia. Burjassot. Spain 3. Surgery department. University of Valencia, Valencia, Spain
We selected 69 eyes of patients with cataracts and without any other ocular or systemic pathology that could distort results. All cataract surgeries were performed by the same experienced surgeon, and an IQ sn60wf IOL (Alcon Alcon�, Inc. Fort Worth Texas, USA) was implanted to all patients involved in the study. After surgery, 25 eyes developed corneal edema and 44 eyes did not. Best corrected visual acuity (BCVA) was measured using EDTRS test under photopic illumination conditions. Subjective refraction was measured before and 1 month after the surgical procedure. Refraction was converted to vectorial notation for the statistical analysis.
Edema group mean age was 74 ? 7 years and control group age was 69 ? 9 years (p=0.10). BCVA obtained 1 month after surgery was 0.85 ? 0.16 decimal units for edema group and 0.97 ? 0.18 decimal units for control group. Mean vector refraction components were M= 0.21 ? 0.57 D; J0= -0.27 ? 0.35 D and J45=-0.004 ? 0.20 D for edema group and M= -0.26 ? 0.65 D; J0= -0,21 ? 0,35 D for non edema group. When we compared both groups, we observed statistical differences in M value (p=0.003) and BCVA value(p=0.006).
Results obtained in this study showed lower BCVA in corneal edema patients than in control group, and an hyperopic shift. Non astigmatic changes related to J0 and J45 values were observed between both groups. This hyperopic value of M value is associated to the overall swelling or to the decreasing in the anterior chamber depth due to the capsulorhexis. So, it seems reasonable that at 1-month visit, edema patients have not yet stabilized optical compensation. Further studies with more post-surgery visits will be necessary in order to establish the optimal moment to prescribe spectacles to these patients.
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