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Mazeyar Saboori, Jenna Kim, Anjali Bhorade, Harrison Gammon, Aaron Y Lee, Arsham Sheybani; The effect of endoscopic cyclophotocoatulation on refractive outcomes when combined with cataract surgery. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2533.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the difference between predicted and actual refractive outcomes after combined ECP and cataract surgery (Phaco-ECP) and cataract surgery alone in patients with open angle glaucoma.
This is a retrospective case series of consecutive patients with open angle glaucoma who underwent Phaco-ECP surgery or cataract surgery alone between January 1, 2005 and November 1, 2010 at Washington University, St. Louis, MO. The primary outcome was the difference between predicted and actual refractive outcome in patients in the Phaco-ECP and cataract surgery alone groups. Predicted refractive errors were calculated using the mean of three different lens calculation formulas. Secondary outcomes included differences between pre- and post-operative intraocular pressure (IOP) and number of ocular hypotensive medications.
Eighty-three patients who underwent Phaco-ECP surgery and 70 patients who underwent cataract surgery alone were included in the analysis. The difference between predicted and actual post-operative refraction was significantly larger and more myopic in the Phaco-ECP group compared to the cataract alone group (-0.269 diopters versus -0.073 diopters respectively, p<0.05). Moreover, this difference was significantly more varied in the Phaco-ECP group by F test p<0.001.
Patients undergoing Phaco-ECP surgery may have post-operative refractive error that may vary from that predicted pre-operatively. Surgeon-tracking of differences between predicted and post-operative refractive error in patients after combined Phaco-ECP is recommended to optimize refractive outcomes. Prospective, larger studies are warranted to better characterize the refractive changes induced by ECP.
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