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Andreas Hartwig, Hema Radhakrishnan, Rob Morris, Jay Dermott, Clare O'Donnell; Is there a link between age and deviation from predicted post-operative refraction (PPOR) after intraocular lens (IOL) implantation?. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1293. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Patient age is likely to influence refractive outcome after IOL implantation but there is little published information on this particular issue. This study aims to investigate the relationship between deviation from PPOR and age, taking into account the keratometry.
In a retrospective analysis, data of 5,855 right eyes were studied after IOL implantation. The data were collected between 2004 and 2013. The mean patient age at the time of surgery was 71.8 ± 11.0 years (range 25 to 99 years). The IOLs implanted were Alcon Acrysoft IQ SN60WF (N = 1,041), Alcon Acrysoft SA60AT (N = 2,008), AMO Tecnis ZCB00 (N = 1,629) and Lentis M Plus LS-313 MF30 multifocal (N = 1,185). Patients were divided in to 3 subgroups based on age at surgery (under 65 years of age; 65-80 years and over 80 years of age).To analyse the effect of age and IOL type on deviation from PPOR, a multivariate analysis of variance was applied with mean keratometry value and deviation from PPOR as dependent variables, and age and IOL type as independent variables. Preoperative spherical equivalent was used as a covariate to control for the effect of pre-operative refraction on the dependent variables.
Mean preoperative spherical equivalent was -0.45 ± 3.81 D and mean preoperative corneal curvature was 43.78 ± 1.85 D. The mean deviation from PPOR was -0.06 ± 0.78 D for the entire cohort. For 64% of eyes the deviation from PPOR was within 0.50 D, for 89% it was within 1.00 D and for 99% it was within 2.00 D. There were statistically significant differences found for the three age groups (F (4, 6504) = 3.3, p = 0.01, Wilks’ Lambda = 1.0), but not for IOL type (F (6, 6504) = 1.7, p = 0.11, Wilks’ Lambda = 1.0). The combination of age and IOL type was also not significant (F (12, 6504) = 1.6, p = 0.08, Wilks’ Lambda = 1.0).
The results suggest that increasing age can have a significant effect on the refractive outcome and might need consideration in the planning of IOL surgery.
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