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Does the post-surgical subjective refraction following small incision cataract surgery change between 1 month and 3 months?

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First Author: D.Rubasinghe UK

Co Author(s):    S. Perera   S. Vaswani                 

Abstract Details

Purpose:

Optimization of the A-constant is important for good refractive outcomes following cataract surgery. Collection and analysis of stable post-operative refractive data is an integral part of this process. Currently there is no standardization as to the best time interval this data should be collected, with very few published studies looking at the timing of post-op refractive stabilization. We analyzed the 1 month and 3-month post-operative subjective refraction in the same eye, to ascertain if the refraction is stable at one month.

Setting:

Refractive outcomes of a single surgeon in private practice Guildford, United Kingdom.

Methods:

155 consecutive eyes that underwent uncomplicated small incision phacoemulsification and lens implant by the same surgeon, had subjective refractions performed at one month and 3 months post operatively. The post- operative sphere, cylinder and spherical equivalent(SE) at the two visits were analyzed. A paired-t test was performed to ascertain the statistical significance of the difference of the means.

Results:

155 eyes of 118 patients were analyzed in this study. The mean age was 68years(SD +/-10). 52% were left eyes. The mean sphere at 1st and 3rd months were +0.21D and +0.27D respectively, while the difference ranged from -1.00D to +1.25D.This was statistically significant at 95% confidence interval(CI)(p-0.017) The mean cylinder at 1st and 3rd months were -0.52D and -0.51D respectively. The change between each visit ranged from -1.00D to +1.00D.This wasn’t statistically significant at 95%CI(p-0.88) The mean SE at 1st and 3rd months were -0.046D and +0.010D respectively.The difference ranged from -0.75D to +1.25D.This was statistically significant at 95%CI(P-0.007)

Conclusions:

This study suggests that there is a statistically significant change in the subjective sphere and spherical equivalent between one month and 3 months post operatively. Interestingly the mean change in cylinder was not statistically significant, suggesting that the change in lens position caused by capsular changes may be a more significant contributory factor for the change in refraction seen between 1 month and 3 months post operatively. Hence use of 3 month post-operative refractive data for A-constant optimization may be more accurate than the one month data.

Financial Disclosure:

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