Cataract surgery in highly myopic patients: does a capsular tension ring improve refractive outcomes?

Session Details

Session Title: Cataract Surgery Instrumentation/Surgical Devices

Session Date/Time: Sunday 11/09/2016 | 10:30-12:00

Paper Time: 11:24

Venue: Hall C1

First Author: : H.Jasim UK

Co Author(s): :    I. Pereni   G. Smith                 

Abstract Details

Purpose:

To see if the use of capsular tension ring (CTR) during routine phacoemulsification with IOL implantation improves refractive outcomes in highly myopic patients.

Setting:

District general hospital in Swindon, UK. Routine day case surgeries performed between April 2004 and April 2014.

Methods:

Retrospective case note review of 242 eyes from 161 patients that underwent routine cataract surgery. Patients were selected from the theatre logbook entries in which records of IOL implants and CTR use are kept. Patients were included if they had an IOL implant power of 15.0 D or less. Patients with major intraoperative complications were excluded (such as dropped nucleus) as this may have affected postoperative outcomes. Cases were then subdivided into two groups; CTR vs. No CTR. The patients’ notes were then reviewed for pre and post- operative refractive and biometric data.

Results:

139 eyes of 92 patients had CTR implanted. 103 eyes of 69 patients did not have CTR implanted (No CTR group). Postoperative refractive error (RE) was calculated as the difference between predicted and post-operative spherical equivalents (SEq). Comparisons between predicted and post-operative refraction revealed a hypermetropic shift in both groups. Mean RE in CTR group was 0.07 (SD 0.55); in the No CTR group mean RE was 0.00 (SD 0.98), p= 0.50. Rates of RE <0.5D in CTR group was 72.8% and 52.0% in the No CTR group. Rates of RE >1.0D in the CTR group was 5.9% and 18.4% in the No CTR group.

Conclusions:

In this well populated study, we found that CTR did not increase predictability of refractive outcomes but there was a trend for higher accuracy with less variance of postoperative refraction. Only the CTR group met the Royal College of Ophthalmologist (RCOphth) guidance of refraction within 1.0D of target in 85% of patients. One can therefore assume that achieving target refraction in highly myopic is more difficult than in routine cases without the use of CTR, particularly in view of the hypermetropic shift seen postoperatively.

Financial Disclosure:

NONE