Abstract
To compare refractive outcomes after cataract surgery in pseudoexfoliation syndrome (PEX) and control eyes and to investigate the accuracy of 3 intraocular lens (IOL) calculation formulas in these eyes. In this prospective comparative study 42 eyes (PEX group) and 38 eyes (control group) of 80 patients were included. The follow-up was 3 months. The refractive prediction error (RPE), mean absolute error (MAE), median absolute error (MedAE) and the percentages of eyes within ± 0.25 D, ± 0.5 D, ± 1.0 D and ± 2.0 D of prediction error were calculated. Three IOL calculation formulas (SRK/T, Barrett Universal II and Hill-RBF) were evaluated. PEX produced statistically significantly higher mean absolute errors and lower percentages of eyes within ± 0.5 D than control eyes in all investigated IOL calculation formulas. There were no statistically significant differences in the median absolute errors between the 3 formulas in either PEX or control eyes. Refractive outcomes after cataract surgery are statistically significantly worse in PEX than in control eyes. All three IOL calculation formulas produced similar results in both PEX and control eyes.Trial registration: ClinicalTrials.gov registration number NCT04783909.
Highlights
Our results show that patients with PEX have more unpredictable refractive outcomes than patients without PEX
It is believed that the stability of postoperative intraocular lens (IOL) position represented by effective lens position (ELP) and postoperative anterior chamber depth (ACD) is one of the key factors in determining refractive outcome of the surgery20,21. Olsen[21] found that 42% of IOL power prediction errors were caused by incorrect estimation of postoperative ACD and 1.0 mm error in estimated postoperative ACD is equivalent to an error of about 1.5 D in the spectacle plane
The accuracy of IOL calculation formulas is limited by their approach to predict the ELP
Summary
The purpose of this study was to evaluate the refractive outcomes of cataract surgery in PEX syndrome and determine which of the commonly used IOL formulas (SRK/T, Barrett Universal II and Hill-RBF) is the best in predicting postoperative refractive outcomes in PEX. The aim of our study was to determine whether new IOL power prediction formulas might improve outcomes in these challenging eyes. The main aim of this study was to compare the ACD changes in PEX and control eyes and methods of assessment of postoperative refraction were not clearly clarified
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