Posters

The reasons for poor refractive outcomes after cataract surgery in short eyes and biometric outliers

Poster Details

First Author: P.Fedor USA

Co Author(s):                        

Abstract Details

Purpose:

To evaluate the eyes with the error of predicted refraction of more than 0.75 D in short eyes with axial length of less than 22.5 mm or anterior chamber depth of less than 2.9 mm with Anterior segment Ultrasound biomicroscopy (AS-UBM).

Setting:

Cataract referral-based private practice with four locations

Methods:

This is a retrospective non-randomized study of 40 eyes of 40 patients that underwent cataract surgery and preoperative AS-UBM due to unusual biometry between the years 2013 and 2020. The inclusion criteria were axial length of less than 22.5 mm or anterior chamber depth of less than 2.9 mm. AS-UBM was performed using Quantel Aviso ultrasound biomicroscopy with quantitative analysis previously described in our research. Most patients underwent testing with Lenstar biometry or Topcon Aladdin biometry and some postoperative AS-UBM analysis.

Results:

Twelve patients out of 40 eyes had error of predicted refraction of more than 0.75 D using several modern formulas. Preoperative AS-UBM images were quantitatively analyzed and revealed 3 main reasons. Two patients had extremely small anterior segment size, two patients extremely large lens and 8 patients had “Vitreous volume enlargement” (VE) syndrome with normal lens and anterior segment size. The average ciliary angle (CA) was 18.4 degrees with significant anterior rotation of ciliary processes. The average scleral spur-to- apex of ciliary processes (RX) distance was 0.38 mm, compared to 0.8 mm in normal eyes.

Conclusions:

Quantitative analysis of AS-UBM is useful in analyzing the reasons for errors of predicted refractions after cataract surgery in short eyes and eyes with abnormally small anterior chamber depth. In short eyes and in outliers AS-UBM is useful in understanding the different anterior segment anatomy and specifically the role of ciliary body and for adjusting the current intraocular lens calculation formulas.

Financial Disclosure:

None