Effect of fixation stability during biometry measurements on refractive prediction accuracy in highly myopic eyes

Abstract

To assess the effect of preoperative biometry fixation stability on postoperative refractive errors in highly myopic cataractous eyes. Eye and ENT Hospital of Fudan University, Shanghai, China. Prospective cohort study. Eyes of highly myopic patients and emmetropic controls were included. Routine ophthalmologic examinations and measurement of fixation stability in the 63% and 95% bivariate contour ellipse areas (BCEAs) were conducted preoperatively. The refractive error from prediction was calculated 1month postoperatively with the SRK/T and Holladay 1 formulas. Univariate and multivariable analyses were performed to identify the factors associated with postoperative refractive errors. The refractive errors were more widely distributed inthe 45 highly myopic eyes than in the 40 emmetropic controleyes: SRK/T, +0.15 diopter [D]±0.80 [SD] and -0.16±0.35 D, respectively; Holladay 1, +0.54±0.79 D and -0.23±0.34 D, respectively. In the highly myopic group, 63% BCEA was correlated with axial length (AL) (P=.021) and posterior subcapsular opacity grade (P=.040). With both formulas, refractive errors and absolute refractive errors were positively correlated with 63% BCEA: SRK/T, P=.010 and P=.001, respectively; Holladay 1, P=.006 and P=.003, respectively. Backward multiple linear regression analysis showed that with both formulas, AL and 63% BCEA were significantly associated with postoperative refractive errors. Poor preoperative biometry fixation stability correlated with long AL and severe posterior subcapsular opacity contributed to significant deviation of refractive errors after cataract surgery in highly myopic eyes.