Refractive shift after simultaneous vitrectomy and cataract surgery

Abstract

Objective To investigate the refractive shift after combined surgery (phacoemulsification,intraocular lens implantation and vitrectomy) by comparing the difference between the predictive and postoperative refractive power. Methods The clinical data of 44 patients (48 eyes) underwent combined surgery (combined group) and 30 patients (50 eyes) underwent cataract surgery (cataract group) were retrospective analyzed. Combined group was further divided into two sub-groups by the kind of tamponade:balanced salt solution group and gas group. Before surgery, axial length and corneal curvature were measured, and the predictive spherical equivalent (PSE) was calculated. Axial length, corneal curvature and actual spherical equivalent (ASE) were measured in six months after surgery. The differences between PSE and ASE were compared between combined group and cataract group, balanced salt solution group and gas group. Results In combined group, the mean PSE was (-0.10±0.42) D and ASE was (- 1.00± 1.10) D,and the difference was significant (t= 6.687, P＜0.05). Patients underwent combined surgery showed a statistically significant myopic shift compared with those underwent simple cataract surgery (t= -3.792,P＜0. 05), the refractive shift of balanced salt solution group and gas group were (-0. 76± 0. 89) and (- 1.19±0.94) D respectively, and there was no significant difference (t= -1.530, P＞0. 05). Conclusion Combined surgery of phacoemulsification and vitrectomy tends to shift the actual refractive status to myopia. Key words: Vitrectomy; Phacoemulsification; Refraction, ocular