Abstract
Objective: To evaluate the accuracy of different intraocular lens (IOL) power calculation formulas and develop prognostic nomograms to predict the risk of postoperative refractive error in primary angle-closure glaucoma (PACG) patients.Methods: A total of 111 eyes with PACG underwent goniosynechialysis combined with phacoemulsification and IOL implantation were included. SRK/T, Barrett II, Hoffer Q, and Kane formulas were used to predict postoperative refraction. Prediction error (PE) and absolute predictive error (APE) produced by the four formulas were calculated and compared. An APE >0.50 D was defined as the event. Binary logistic regression analysis and prognostic nomogram models were conducted to investigate reliable predictors associated with postoperative refraction.Results: The Kane (−0.06 D) and Barrett II (−0.07 D) formulas had mean prediction error close to zero (p = 0.44, p = 0.41, respectively). The Hoffer Q and SRK/T produced significantly myopic outcomes (p = 0.003, p = 0.013, respectively). The percentage of eyes within ± 0.5 D was 49.5% (55/111), 44.1% (49/111), 43.2% (48/111), and 49.5% (54/111), for the Kane, Barrett II, Hoffer Q, and SRK/T formula, respectively. Nomogram showed that AL had the greatest impact on the refractive outcomes, indicating a shorter preoperative AL is associated with a greater probability of refractive error event. The area under the receiver operator curve (AUC) of the nomogram for the Kane, Barrett II, Hoffer Q, and SRK/T was 0.690, 0.701, 0.708, and 0.676, respectively.Conclusions: The Kane and Barrett II formulas were comparable, and they outperformed Hoffer Q and SRK/T in the total eyes with PACG receiving cataract surgery combined with goniosynechialysis. The developed nomogram models can effectively predict the occurrence of postoperative refractive error events.
Highlights
Primary angle-closure glaucoma (PACG) is one of the leading causes of irreversible blindness, disproportionally affecting Asians [1]
PACG is characterized by progressively peripheral anterior synechiae which leads to closure of the anterior chamber drainage angle with subsequently elevated intraocular pressure (IOP)
It has been reported that compared with trabeculectomy, goniosynechialysis (GSL) combined with phacoemulsification and intraocular lens (IOL) implantation could reduce peripheral anterior synechiae, remove pupillary block, and relieve the crowded anterior chamber, which has become an effective and safe treatment option for patients with PACG with coexisting cataract [3, 4]
Summary
Primary angle-closure glaucoma (PACG) is one of the leading causes of irreversible blindness, disproportionally affecting Asians [1]. PACG is characterized by progressively peripheral anterior synechiae which leads to closure of the anterior chamber drainage angle with subsequently elevated intraocular pressure (IOP). It has been reported that compared with trabeculectomy, goniosynechialysis (GSL) combined with phacoemulsification and intraocular lens (IOL) implantation (phaco-IOL-GSL) could reduce peripheral anterior synechiae, remove pupillary block, and relieve the crowded anterior chamber, which has become an effective and safe treatment option for patients with PACG with coexisting cataract [3, 4]. The inaccurate IOL power prediction in patients with PACG can be a significant problem resulting in unsatisfying postoperative refractive outcomes. Chosen IOL power calculation formula [6], corneal edema which affects the accuracy of biometry measurement, ocular anatomy change, and capsular apparatus shifting after the cataract surgery maybe the reasons for the inaccurate IOL power prediction in patients with PACG [7, 8]. Few works have investigated the performance of different IOL formulas in eyes with PACG
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
