Abstract
Purpose: to assess effect of eye drops instillation on the refractive power of the cornea and potential intraocular lens (IOL) power calculation errors appearing related within.Patients and methods. There were 478 patients divided in 3 groups: 1st — patients without glaucoma and topical treatment (n = 325); 2nd — individuals with primary open angle glaucoma (POAG) on treatment (n = 122); 3rd — patients with POAG and previous trabeculectomy (TE) without using eye drops (n = 31). For each patient keratometry was performed by IOL-Master 500. Mean preoperative keratometry and corneal astigmatism were compared within IOL calculation error received by Barrett Universal II formula 1 month after phacoemulsification (PE).Results. Mean keratometry was significantly (p < 0.001) less (0.6 D) at the 1st group (44.00 ± 1.96 D) versus 2nd group (44.6 ± 1.76 D). Cancellation of topical eye drops due to TE leads to insignificant decline of corneal curvature (from 44.6 ± 1.76 D to 44.1 ± 1.59 D). There was no any difference in corneal astigmatism level between study groups (0.92 ± 2.23 D, 0.8 ± 0.59 D and 0.86 ± 0.50 D for groups respectively) as like as no distinction in IOL calculation error in these groups (–0.08 ± 0.57 D, –0.06 ± 0.6 D and 0.003 ± 0.61 D). However, men have more flatter cornea (43.6 ± 1.98 D) than women (44.4 ± 1.80 D) (p < 0.001). Mean keratometry at the age group 60–74 years was less (43.7 ± 2.3 D) than at 75–90 years (44.4 ± 1.54) (p = 0.002).Conclusion. Patients with coexistent cataract and glaucoma on treatment require special attention in IOL calculation. To avoid keratometric errors it is recommended to prescribe lubricants and change hypotensive eye drops to preservative-free analogs to form a stable tear film.
Highlights
Проблема еще более усугубляется при наличии у пациента сопутствующей глаукомы
478 patients divided in 3 groups
For each patient keratometry was performed by intraocular lens (IOL)-Master 500
Summary
Цель: оценка влияния гипотензивной терапии на преломляющую силу роговицы и вероятность обусловленного этим возникновения ошибок расчета ИОЛ. Сравнивали показатели средней кератометрии и роговичного астигматизма до операции, а также ошибку расчета ИОЛ по формуле Barrett Universal II через 1 месяц после факоэмульсификации (ФЭ). Отмена инстилляций гипотензивных препаратов у пациентов третьей группы привела к незначительному ослаблению преломляющей силы роговицы (с 44,6 ± 1,76 до 44,1 ± 1,59 дптр). Однако у мужчин преломляющая сила роговицы оказалась достоверно (p < 0,001) ниже (43,6 ± 1,98 дптр), чем у женщин (44,4 ± 1,80 дптр), а усредненные показатели кератометрии (43,7 ± 2,3 дптр) у пожилых были достоверно меньше (p = 0,002), чем у пациентов старческого возраста (44,4 ± 1,54 дптр). Пациенты с катарактой и сопутствующим медикаментозным лечением глаукомы требуют особого внимания при расчете ИОЛ. Влияние инстилляций гипотензивных препаратов на преломляющую силу роговицы. Nikolaenko Saint-Petersburg Multifield Hospital No 2 Uchebniy lane, 5, Saint-Petersburg, 194354, Russian Federation
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