Factors affecting predictability of postoperative refraction after intraocular lens implantation in congenital cataract

Session Details

Session Title: Cataract Surgery Paediatric/Complications/Management

Session Date/Time: Monday 09/10/2017 | 16:30-18:00

Paper Time: 17:12

Venue: Room 4.1

First Author: : S.Lee SOUTH KOREA

Co Author(s): :    B. Lee   J. Kim   Y. Yu              

Abstract Details

Purpose:

To analyze the factors affecting the predictability of the postoperative refraction after intraocular lens (IOL) implantation in pediatric patients with congenital cataract

Setting:

Seoul National University Children’s Hospital, Seoul, Korea

Methods:

Medical records of the 338 patients (481 eyes) were analyzed retrospectively who underwent in-the-bag IOL implantation for congenital cataract by an experienced pediatric ophthalmologist (Y.Y.) during 1999–2014. Target refraction of the inserted IOL were calculated using three IOL power calculating formulae including Sanders-Retzlaff-Kraff (SRK)-II, SRK/T and Hoffer-Q. The results were compared with the actual postoperative refraction which was measured 4 to 10 weeks postoperatively. The correlations between prediction error (PE) and preoperative variables (age at IOL implantation (age), axial length, and keratometry) according to the formula were analyzed.

Results:

The mean age was 43.64±30.06 (11~201) months. With SRK-II, SRK/T, Hoffer-Q formula, mean PE (MPE) were 0.81±1.69D, 1.12±1.77D, 1.90±2.28D, respectively and mean absolute error (MAE) were 1.40±1.24D, 1.50±1.47D,2.09±2.10D, respectively (p<0.001). PE showed significant correlation with age (SRK-II: r=−0.311; SRK/T: r=−0.319; Hoffer-Q: r=−0.384; all p<0.001) and axial length (SRK/T: r=−0.300; Hoffer-Q: r=−0.522; all p<0.001). With subgroup analysis by age (0~24, 25~60, 61~120, 121~203 months), the MPE and MAE were the highest within 24 months and converged to zero with increased age.

Conclusions:

With common IOL power calculating formulae, the MPE and MAE after successful IOL implantation in patients with congenital cataract are higher when the age is younger. Adjustment of the IOL power considering the age can improve the predictability of the postoperative refraction. Among the 3 formulae evaluated, SRK-II consistently provided the best predictive results within 5 years of age.

Financial Disclosure:

NONE