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Refractive outcomes after immediate primary phacoemulsification for acute primary angle closure
Takafumi Suzuki1,2, Yoshiki Ueta3, Naoko Tachi3,4
1Department of Ophthalmology, Shinseikai Toyama Hospital, Imizu, Japan. etoile1914100@gmail.com.
Scientific Reports
|August 16, 2023
Summary
Phacoemulsification in acute primary angle closure (APAC) eyes showed significant changes in axial length and anterior chamber depth. Refractive prediction error was higher in APAC eyes, necessitating careful consideration due to preoperative axial length elongation from high intraocular pressure.
Area of Science:
- Ophthalmology
- Refractive Surgery
- Glaucoma Research
Background:
- Acute primary angle closure (APAC) is a condition requiring prompt intervention.
- Phacoemulsification is a common surgical treatment for cataracts and can be used in APAC.
- Accurate refractive outcomes are crucial following cataract surgery, especially in complex cases like APAC.
Purpose of the Study:
- To investigate the refractive outcomes after immediate primary phacoemulsification in APAC eyes compared to their fellow eyes.
- To evaluate the accuracy of different intraocular lens calculation formulas in APAC eyes.
- To analyze changes in ocular biometric parameters, including axial length and anterior chamber depth, post-surgery.
Main Methods:
- A comparative study involving 64 eyes (32 APAC eyes and 32 fellow eyes).
- Measurements included best-corrected visual acuity, intraocular pressure, keratometry, spherical equivalent, axial length, central corneal thickness, and anterior chamber depth.
- Refractive prediction error and absolute error were calculated using SRK/T, Barrett Universal II, Hill-Radial Basis Function Version 3.0, and Kane formulas.
Main Results:
- Both APAC and fellow eyes showed significant axial length decrease and anterior chamber depth increase post-surgery (p < 0.001).
- The change in axial length differed significantly between APAC and fellow eyes (p = 0.007).
- APAC eyes exhibited significantly larger refractive prediction error and absolute error with certain formulas (SRK/T, Barrett, RBF 3.0) compared to fellow eyes.
Conclusions:
- Immediate primary phacoemulsification impacts ocular biometry in APAC eyes.
- Standard refractive prediction formulas may have limitations in APAC eyes due to preoperative axial length elongation caused by high intraocular pressure.
- Ophthalmologists should exercise caution and consider potential refractive prediction errors in APAC patients undergoing phacoemulsification.
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