Residual refractive errors in pseudophakic eyes and related factors:a population-based study

AIM: To determine residual refractive error after cataract surgery in pseudophakic eyes and its relationship with age, sex, and axial length(AL).METHODS: In this population-based cross-sectional study, the sampling was performed on individuals aged 60y and above in Tehran, Iran using a multi-stage stratified random cluster sampling method. Pseudophakic eyes with a best-corrected visual acuity of 20/32 or better were analyzed and their refractive results were reported.RESULTS: The mean spherical equivalent(SE) refraction was-0.34±0.97 diopters(D) and the mean absolute SE was 0.72±0.74 D with a median of 0.5 D. Moreover, 32.68%(n=546, 95%CI: 30.27%-35.08%), 53.67%(n=900, 95%CI: 51.23%-56.1%), 68.99%(n=1157, 95%CI: 66.96%-71.02%), and 79.73%(n=1337, 95%CI: 77.69%-81.76%) of the eyes had a residual SE within ±0.25, ±0.50, ±0.75, and ±1.00 D of emmetropia, respectively. According to the multiple logistic regression model, increasing age was associated with a statistically significant decrease in predictability for all cut points. Moreover, the predictability based on all cut points was significantly lower in individuals with an AL longer than 24.5 mm than in those with an AL between 22 to 24.5 mm.CONCLUSION: Based on the results, the accuracy of intraocular lens(IOL) power calculation is lower for those who underwent cataract surgery during the last 5y in Tehran, Iran. Among the most important influential factors, the choice of IOL or it's power disproportionate to eye conditions and age can be mentioned.

Refractive errors in high myopic eyes after phacovitrectomy for macular hole

AIM: To examine the refractive prediction error in high myopic eyes after phacovitrectomy.METHODS: This retrospective comparative case series included 91 eyes(18 high myopic eyes and 73 non-high myopic eyes) of 91 patients who underwent successful phacovitrectomy(phacoemulsification, intraocular lens implantation, and pars plana vitrectomy). The high myopic eyes were defined as the eye with more than 26.0mm of axial length. The postoperative prediction error of mean error and mean absolute error were evaluated at4 mo postoperatively. Axial length and keratometry measurement were performed preoperatively and 4mo postoperatively using the IOL Master.RESULTS: The refractive outcome after phacovitrectomy showed significantly greater myopic shift in the high myopic eyes [-1.08 ±0.87 diopters(D)] than that in the non-high myopic eyes(-0.43 ±0.63 D, P =0.004). Axial length and keratometric value in the high myopic eyes were significantly increased(P =0.043, 0.037 respectively),whereas those in the non-high myopic group were not significantly increased(P =0.135, 0.347 respectively). The change of the axial length in the myopic eye(0.46±0.28 mm)was greater than that in the non- high myopic eye(0.11 ± 0.34 mm; P 【0.001).CONCLUSION: High myopic eyes showed more myopic shift than non-high myopic eyes after phacovitrectomy.The cause of myopic shift in high myopic eyes seems tobe attributed to actual elongation of the axial length in high myopia.

儿童白内障人工晶状体植入后眼轴及屈光变化

目的探讨儿童先天性白内障人工晶状体度数的选择。方法行白内障人工晶状体植入术患儿110例（132眼）。按手术时年龄分为2组；A组3～6岁，50例（64眼），B组7～14岁，60例（68眼）。观察术后1周至1年眼轴长度和屈光度的变化。结果A组眼轴长度变化（3．25±1．42）mm，屈光度变化为（4．08±2．96）D，B组眼轴长度变化为（0．75±0．81）mm，屈光度变化为（2．15±1．21）D。结论儿童白内障人工晶状体植入术后有近视移漂倾向，故人工晶状体植入度数宜以适当欠矫为原则。