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Justyna Helena Krowicka, Samir I Sayegh; Planning and Performing Cataract Surgery in Poland - Old and New Strategies and Outcomes. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2010.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To examine the distribution, visual acuity, methods and refractive results of cataract surgery performed in a clinic in South-Western Poland and identify tools for improvement of outcomes.
Methods: The record of 74 eyes of 50 patients operated of cataracts by phacoemulsification in 2014 and 2015 were examined and analyzed retrospectively. The male to female ratio was 1:2 (32% male, 68% female) the preoperative visual acuity ranged from HM to 20/70 and the spherical equivalent ranged from +6.5 to -18.5 with astigmatism ranging from 0.25 to 4.0. All known comorbidities were recorded. Measurements were performed using manual keratometry, Alcon's Ultrascan A-scan ultrasound (contact), EM-3000 Specular Microscope and the SRK II formula was used for the majority of cases.Analysis was performed to determine if the outcome would have been better with the use of a next generation formula. A universal calculator, UniversIOL, allowing the use of multiple formulas, analysis of astigmatism and scoring the probability of refractive surprises, was also used to reevaluate the results.
The final best corrected visual acuity ranged from 0.001 (1.3%) to 1.0 (25%) and was limited mainly by comorbidities such as glaucomatous neuropathy (23.5%), AMD (20.5%) and diabetic retinopathy (13%). The final refraction was 64% within 0.5 D of target, 84% within 1D of target with 8% between 1 and 2 diopters of target and 8% with more than 2D of deviation from intended target. Refractive surprisese correlated with very short axila length and/or very flat keratometry and were therefore more common in hyperopic patients. Patient satisfaction was nearly 100% based on a follow up survey. The use of the SRK/T or Haigis formula and an analysis tool from UniversIOL was shown to improve results to a significant degree. The use of toric IOLs or LRIs may have benefited 17% of patients with significant (postoperative) corneal astigmatism.
Current methods of planning and performing cataract surgery yielded very good results with a high degree of patient satisfaction They can be improved upon by careful follow up of outcomes and use of powerful tools of IOL calculation and analysis.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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