Factors affecting refractive outcome after cataract surgery in patients with a history of acute primary angle closure

This study was conducted to evaluate the influence of preoperative or intraoperative factors on the refractive outcome after cataract surgery in patients with a history of acute primary angle closure (APAC).

Eyes were divided into two groups: those with stable refractive outcome and those with unstable refractive outcome at 8 weeks after uneventful cataract surgery. Univariate and multivariate regression analyses were performed to investigate factors associated with the postoperative refractive outcome.

Fifty-three eyes of 53 patients with a history of APAC (21 eyes with stable refractive outcome, 32 eyes with unstable refractive outcome) were enrolled. In the univariate regression analysis, longer duration of APAC [odds ratio (OR) 1.328; 95 % confidence interval (CI) 1.137-1.552; P = 0.001] and poor preoperative best corrected visual acuity (OR 4.648; 95 % CI 1.071-20.168; P = 0.040) were associated with unstable refractive outcome after cataract surgery in patients with a history of APAC. In the multivariate regression analysis, the duration of APAC was the only independent factor predicting refractive outcome after cataract surgery in patients with a history of APAC (OR 1.317; 95 % CI 1.113-1.558; P = 0.001).

Normalization of elevated intraocular pressure as soon as possible after APAC onset is recommended to obtain a stable refractive outcome after cataract surgery in patients with a history of APAC.