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Refractive changes after phacoemulsification combined with deep sclerectomy assisted by corneal topography.

Juan Corcostegui¹, Gema Rebolleda, Francisco J Muñoz-Negrete

¹Glaucoma Unit, Ophthalmology Department, Hospital Ramón y Cajal, University of Alcala, Madrid, Spain.

Journal of Cataract and Refractive Surgery

|November 3, 2004

Summary

Phacoemulsification combined with deep sclerectomy resulted in minimal surgically induced refractive change (SIRC). Refractive outcomes were mild and not clinically significant for most patients undergoing this combined glaucoma and cataract surgery.

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Area of Science:

Ophthalmology
Refractive Surgery
Glaucoma Surgery

Background:

Cataract surgery and glaucoma procedures are often combined.
Evaluating refractive outcomes is crucial for patient satisfaction after ocular surgery.

Purpose of the Study:

To assess the surgically induced refractive change (SIRC) following phacoemulsification combined with deep sclerectomy.

Main Methods:

Prospective study of 38 eyes from 35 patients (mean age 77).
Phacoemulsification via clear corneal approach combined with deep sclerectomy and hyaluronic acid implant.
Computerized keratography used preoperatively and at 1 and 3 months postoperatively.
SIRC calculated using the Holladay-Cravy-Koch method and expressed vectorially.

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Main Results:

The magnitude of mean SIRC components was very small.
No significant changes in vectorial components were observed at 1 or 3 months.
While 47.4% of patients showed induced with-the-rule astigmatism, the mean change was <0.50 D and not statistically significant.
Mean spherical postoperative change was greater in left eyes than right eyes (P=.05).

Conclusions:

Phacoemulsification combined with deep sclerectomy leads to mild and clinically insignificant refractive changes.
Potential differences in spherical change between eyes may be linked to the phacoemulsification approach.