Posters

Cataract patients and pterygium: predictability of intraocular lens power calculation

Poster Details

First Author: A.Liaska GREECE

Co Author(s):    T. Pallantzas   E. Makri   S. Stamelou   K. Andrianopoulou   D. Mitsiou        

Abstract Details

Purpose:

Pterygium often coexists with cataract in older patients.The presence of pterygium reduces the refractive accuracy of Intraocular lens(IOL)power calculation in such patients.One-step procedure(simultaneous pterygium excision with cataract operation)or two-step procedure(pterygium excision followed by phacoemulsification)offer specific advantages and have been analyzed in the literature,however in some of these patients the postoperative course of pterygium surgery may be troublesome in a significant degree overriding the otherwise smooth postoperative course of an uneventful cataract surgery.The aim of the study is to examine the feasibility and the accuracy of IOL power calculation in the presence of pterygium in patients undergoing phacoemulsification with IOL implantation.

Setting:

Department of Ophthalmology, General Hospital of Lamia, Lamia, Greece

Methods:

714 charts of cataract patients undergone phacoemulcification with IOL implantation were reviewed. 11 patients  with pterygium and adequate postoperative data had cataract operation (phacoemulsification, clear cornea temporal approach) without pterygium excision. IOL power calculation was performed using the keratometric value of the steep axis considering the presence and the type of astigmatism as well as the IOL power calculation in the fellow eye. Anisometropia patients were excluded. The refractive target was emmetropia or low myopia.  Keratometric values (k-values), axial length and postoperative refractive correction of operated and fellow eye were compared using aparametric methods (Wilcoxon signed rank sum test, p-value).

Results:

There is not a statistically significant difference between :k-steep vs fellow eye k-steep (p= 0.8232),axial length vs fellow eye axial length(p=0.2130), postoperative refractive correction(cylinder)vs fellow eye astigmatism at corneal plane(p= 0.3978). There is a statistically significant difference between K-flat vs fellow eye k-flat (horizontal axis)(p=0.0033).  logMAR was significantly improved from 3 - 0.3(median 1) preoperatively to 0.15-0(median 0) postoperatively(p=0.0032). 10/11 of the patients were within the target refraction. Postoperative astigmatism varied from 0 to 1.5 D. Some difficulties were encountered during capsulorhexis and phacoemulsification nasally due to distortion of the corneal surface and/or mild corneal opacities related to the pterygium.

Conclusions:

phacoemulsification with IOL implantation without pterygium removal is safe and effective in eyes with medium sized pterygia and visually significant cataract. Specific modifications in IOL power calculation taking into consideration the status of the fellow eye may be necessary in these patients.

Financial Disclosure:

None