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Renu V. Jivrajka, Maya Shammas, John H. Shammas; Improving Second Eye Refractive Error in Patients Undergoing Cataract Surgery. Invest. Ophthalmol. Vis. Sci. 2011;52(14):2790.
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To assess the refractive error in the second to be operated eye when the IOL power was modified to correct 50% of the error from the first eye when such an error exceeded 0.50 D.
250 consecutive patients who had their first eye’s cataract operated on one to three months earlier were scheduled for cataract surgery in the second eye between January and May 2010. Both eyes were measured at the same time with the IOLMaster, version 5.2 prior to the first eye’s surgery. The first eye refractive error (FERE) was evaluated before the second eye’s surgery. FERE exceeded 0.50 D in 97 patients (38.8%). When choosing the IOL power for the second eye in these patients, the calculations were adjusted to correct 50% of the error from the first eye. The adjusted second eye refractive error (aSERE) was evaluated 6 to 8 weeks after surgery, and compared to FERE. Statistical analysis was performed with the paired t test.
The median absolute aSERE was significantly lower in the second eye compared to the median absolute FERE in these 97 eyes (0.39 v/s 0.77 D, p=1.85E-11). The difference was also statistically significant in the 47 patients where FERE was between -0.50 and -1.00 D (0.39 v/s 0.66 D. p=0.0004), in 15 patients where FERE exceeded -1.00 D (0.65 v/s 1.25 D, p=0.0008), in the 24 patients where FERE was between +0.50 and +1.00 D (0.32 v/s 0.65 D, p=8.0E-06), and in the 11 patients where FERE exceeded +1.00 D (0.57 v/s 1.19 D, p=0.005). The median aSERE was also compared to a potential non-adjusted SERE (nSERE) and a potential fully-adjusted SERE (fSERE). aSERE were lower than nSERE (0.39 v/s 0.50, p=0.0001) and than fSERE (0.39 v/s 0.44, p=0.06).
In patients undergoing bilateral sequential cataract surgery, and where the FERE exceeded 0.50 D, the refractive error of the second eye can be improved by modifying the IOL power to correct 50% of the error from the first eye.
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