Posters

Refractive outcomes of a single-step and a two-step approach for silicone oil removal and cataract surgery

Poster Details

First Author: D.Gouider TUNISIA

Co Author(s):    H. Zgolli   S. Mabrouk   L. Nacef              

Abstract Details

Purpose:

To study the functional outcomes of a one-step and a two-step approach for silicone oil removal (SOR) and phacoemulsification (PKE)

Setting:

Institute Hedi Rais of ophthalmology, Department A.

Methods:

Case records of patients who had SOR and PKE from July 2018 to December 2019, were retrospectively analyzed. A total of 100 eyes that underwent ultrasound biometry (UB) were studied; 65 eyes had SOR and PKE at a single surgery (Group A), where UB was done in a silicone oil (SO) filled eye. The other 35 eyes had SOR followed by PKE later (Group B), where UB was done in a fluid-filled eye. The refractive error (RE) and best-corrected visual acuity (BCVA) at 45 days and 3 months postoperatively were compared.

Results:

Base axial length, lens power and refractive error were comparable in both groups. Myopic displacement (6.28 ± 5.47 diopters) was noted in 96% of the eyes; 52% of the eyes had a refractive error of ≤1.5D at 3 months postoperatively. The latter was more significant in Group A (-1.57 ± 2.04) versus groupe B (-0.64 ± 1.45) (p <0.001). Best corrected visual acuity was significantly lower in Group A at immediate postoperative and at 45 days (p=0,002), but comparable in both groups at 3 months postoperatively.

Conclusions:

The refractive changes caused by the presence of silicone oil in the eye are well studied. Indeed, the silicone filled eye lends itself to an aberrant calculation of the IOL’spower, effectively the speed of the sound wave is altered when estimating axial length. Thus the silicone-filled eye generally undergoes a myopic displacement during the calculation of the implant. Therefore, a 2-step approach with initial silicone ablation followed by implant calculation and phacoemulsification will guarantee a better refractive result. However, ideally, a calculation of the implant power prior to vitrectomy and silicone oil tamponade should be performed.

Financial Disclosure:

None