Power prediction accuracy of intraocular lens after cataract surgery for patients with angle-closure or angle-closure glaucoma

Abstract

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[영문]

Purpose: To assess the accuracy of intraocular lens (IOL) power predictions for cataract surgery in angle closure glaucoma (ACG) patients and to compare the accuracy of IOL power prediction for different types of artificial IOLs.Methods: This prospective comparative case series included 35 eyes from 35 patients with primary ACG and 36 eyes from 36 subjects with normal open angles undergoing uneventful cataract surgery. In the ACG group, 17 eyes had three-piece IOL implantation and 18 eyes had one-piece IOL implantation. In the normal open angle group, 18 eyes had three-piece IOL implantation and 18 eyes had one-piece IOL implantation. Pre-operative anterior segment biometry including anterior chamber depth, lens thickness and axial length was compared between the angle closure group and the normal group for both one-piece and three-piece IOL implantations. Using the SRK/T formula, the absolute values of the differences between the predicted and actual spherical equivalent (SE) refractive errors were analyzed between the four groups. The power of implanted IOL was calculated to predict postoperative SE by various formulas: SRK II, Haigis, and Hoffer Q by post-hoc analysis in each group. The predictive accuracy of the formula was analyzed by comparing the mean difference between the predicted and actual postoperative SE, that is, the mean absolute error (MAE). Results: In the one-piece IOL implantation group, there was no difference in MAE between the ACG and normal open angle group (P=0.60). In the three-piece IOL implantation group, the MAE of the ACG group was larger than that of the normal open angle group (P=0.002). The MAEs calculated by SRK/T, SRK II, Haigis, and Hoffer Q were not significantly different between groups.Conclusion: No difference in IOL power prediction was observed between SRK/T and other formulas. One-piece IOL was more accurate in ACG patients than the three-piece IOL, which may be associated with IOL haptic configuration or design.