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Author Spotlight: Advancements in Refractive Surgical Correction for Presbyopia and Exploring Postoperative Visual Acuity
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Factors Associated with Refractive Prediction Error after Phacotrabeculectomy.

Jung Hye Shin1,2, Seok Hwan Kim3, Sohee Oh4

  • 1Department of Ophthalmology, Seoul National University College of Medicine, Seoul 07061, Republic of Korea.

Journal of Clinical Medicine
|September 9, 2023
PubMed
Summary

Phacotrabeculectomy results in greater refractive prediction errors than phacoemulsification, particularly in eyes with high intraocular pressure, shallow anterior chambers, or extreme axial lengths.

Keywords:
cataract surgeryglaucomaphacotrabeculectomyprediction errorrefraction

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Area of Science:

  • Ophthalmology
  • Refractive Surgery
  • Glaucoma Surgery

Background:

  • Accurate refractive outcomes are crucial after cataract surgery.
  • Phacotrabeculectomy combines cataract removal with glaucoma surgery, potentially impacting refractive predictability.
  • Phacoemulsification is a standard cataract surgery technique.

Purpose of the Study:

  • To compare refractive prediction errors between phacotrabeculectomy and phacoemulsification.
  • To identify factors influencing refractive prediction errors in these procedures.

Main Methods:

  • A retrospective matched-pair analysis comparing 48 eyes undergoing phacotrabeculectomy with 48 eyes undergoing phacoemulsification.
  • Refractive prediction error calculated using the Barrett Universal II formula versus actual postoperative refraction.
  • Multivariable regression analysis to identify associated factors.

Main Results:

  • Phacotrabeculectomy group had significantly larger absolute refractive prediction errors (0.51 D) than the phacoemulsification group (0.38 D).
  • Longer axial length (AL) and higher intraocular pressure (IOP) difference were associated with larger prediction errors.
  • Shallower anterior chamber depth (ACD) and larger IOP difference correlated with hyperopic shifts post-phacotrabeculectomy.

Conclusions:

  • Phacotrabeculectomy is associated with less predictable refractive outcomes compared to phacoemulsification.
  • Preoperative factors like high IOP, shallow ACD, and extreme AL require careful consideration in phacotrabeculectomy planning.
  • Surgeons should anticipate potential refractive surprises in specific patient profiles undergoing phacotrabeculectomy.