Axial Length Shortening After Cataract Surgery: New Approach to Solve the Question

To check if optical biometry can detect eventual corneal power (Km) and axial length (AL) cataract surgery-related changes that could influence the refractive outcome.

Patients scheduled for sequential bilateral cataract surgery between January and September 2017 were included in the present study. One hundred ninety-six eyes of 98 patients (48 males) were selected. Before surgery of the first eye, patients underwent a complete ophthalmic examination, including IOLMaster biometry; the same evaluations were repeated in both eyes the day before the fellow eye cataract surgery, performed at least 2 months after the first one. The differences in Km and AL in the first operated eyes were evaluated, and the fellow eyes were used as controls.

Km differences in the operated eyes ranged from -1.97 to +0.98 diopter (D) (mean = -0.02 ± 0.36 D) (P = 0.89); in the nonoperated eyes they ranged from -0.6 to +0.7 D (mean = 0 ± 0.20 D) (P = 0.91). The AL differences (pseudophakic option) in the operated eyes ranged from -0.35 to +0.15 mm (mean = -0.10 ± 0.08 mm) (P < 0.001); with the aphakic option they ranged from -0.24 to + 0.26 mm (mean = 0.01 ± 0.08 mm) (P= 0.38). In the nonoperated eyes, the AL differences ranged from -0.04 to +0.06 mm (mean= 0 ± 0.02 mm) (P = 0.02).

The modern phaco-technique seems not to induce changes in Km and AL, supporting the hypothesis that the differences in AL are due to an incorrect estimation in pseudophakic eyes.

The results of our study may improve the AL measurements in pseudophakic eyes.