Background:To evaluate the predictability of refraction following immediate sequential bilateral cataract surgery(ISBCS)performed under general anaesthesia.Methods:This is a retrospective review of all ISBCS performed...Background:To evaluate the predictability of refraction following immediate sequential bilateral cataract surgery(ISBCS)performed under general anaesthesia.Methods:This is a retrospective review of all ISBCS performed at Kantonsspital Winterthur,Switzerland,between April 2000 and September 2013.The case notes of 250 patients were reviewed.Patients having full refraction reported(110 patients/220 eyes)were included.210(95%)eyes had a straight forward phacoemulsification with posterior chamber intraocular lens implantation,seven eyes had a planned extracapsular cataract extraction(ECCE);three eyes had an intracapsular cataract extraction.Results:Both eyes of 110 patients(64 women,46 men)with a mean age of 79.0 years,standard deviation(SD)±11.4(range 26 to 97 years)were included.Median preoperative best corrected visual acuity(BCVA)was 0.5 LogMAR in the first eye,the interquartile range(IQR)was[0.4,1.2];0.7 LogMAR in the second eye with IQR[0.4,1.8].At one month,the median BCVA was 0.2 LogMAR,IQR[0.1,0.3]in the first eye,median BCVA was 0.1 LogMAR and IQR[0.0,0.5]in the second eye.There were 3 eyes(3%)that lost 3 lines or more in BCVA at one month(control vs.pre-operatively).In all three cases,poor visual acuity had been recorded pre-operatively(>1 LogMAR).Achieved refraction was within±1.0 D of the target in 83%of eyes.There were only 5%(n=6)of cases where if delayed sequential bilateral extraction had been performed could potentially intraocular lens(IOL)choice have been adjusted,in four of these cases,target refraction was within±1.0 D in the second eye.Conclusions:ISBCS performed under general anaesthesia achieves target refraction in 83%of eyes after consideration of complications,ocular co-morbidities and systemic restrictions.In the majority of cases where IOL power calculation could be considered,the achieved refraction of the second surgical eye was within±1.0 D of intended refraction.This undermines the utility of IOL power adjustments in the second surgical eye.展开更多
文摘Background:To evaluate the predictability of refraction following immediate sequential bilateral cataract surgery(ISBCS)performed under general anaesthesia.Methods:This is a retrospective review of all ISBCS performed at Kantonsspital Winterthur,Switzerland,between April 2000 and September 2013.The case notes of 250 patients were reviewed.Patients having full refraction reported(110 patients/220 eyes)were included.210(95%)eyes had a straight forward phacoemulsification with posterior chamber intraocular lens implantation,seven eyes had a planned extracapsular cataract extraction(ECCE);three eyes had an intracapsular cataract extraction.Results:Both eyes of 110 patients(64 women,46 men)with a mean age of 79.0 years,standard deviation(SD)±11.4(range 26 to 97 years)were included.Median preoperative best corrected visual acuity(BCVA)was 0.5 LogMAR in the first eye,the interquartile range(IQR)was[0.4,1.2];0.7 LogMAR in the second eye with IQR[0.4,1.8].At one month,the median BCVA was 0.2 LogMAR,IQR[0.1,0.3]in the first eye,median BCVA was 0.1 LogMAR and IQR[0.0,0.5]in the second eye.There were 3 eyes(3%)that lost 3 lines or more in BCVA at one month(control vs.pre-operatively).In all three cases,poor visual acuity had been recorded pre-operatively(>1 LogMAR).Achieved refraction was within±1.0 D of the target in 83%of eyes.There were only 5%(n=6)of cases where if delayed sequential bilateral extraction had been performed could potentially intraocular lens(IOL)choice have been adjusted,in four of these cases,target refraction was within±1.0 D in the second eye.Conclusions:ISBCS performed under general anaesthesia achieves target refraction in 83%of eyes after consideration of complications,ocular co-morbidities and systemic restrictions.In the majority of cases where IOL power calculation could be considered,the achieved refraction of the second surgical eye was within±1.0 D of intended refraction.This undermines the utility of IOL power adjustments in the second surgical eye.
