Abstract
Purpose :
An important part of cataract surgery is having excellent postoperative refractive outcomes. Therefore, postoperative refractive surprise is a challenge of significant interest in achieving desired vision. As populations age around the world, the incidence of glaucoma and cataract continue to rise. Further understanding of refractive outcomes in glaucoma patients undergoing cataract surgery is essential. In this study, we investigate post-cataract refractive outcomes of glaucoma versus non-glaucoma patients without any concomitant visually significant co-morbidities.
Methods :
Patients who underwent uncomplicated phacoemulsification cataract surgery from 2007 to 2018 were enrolled in this retrospective cohort study. The first eye of each patient that qualified was included. We excluded patients with visually significant ocular or systemic comorbidities, prior non-refractive eye surgeries, combined cataract surgeries, and patients requiring additional procedures post op. Refractive outcome at postoperative 1 month was evaluated between control and glaucoma groups, as well as among glaucoma types.
Results :
A total of 503 patients (354 in non-glaucoma and 149 in glaucoma) were included. Among the control group, 67.8% and 95.2% of patients fall within 0.5D and 1.0D of target respectively compared with 65.7% (P=0.659) and 89.9% (P= 0.027) in the glaucoma group. Refractive outcomes were compared between glaucoma types and no significant difference were found in percentage of patients within 0.5D and 1.0D of target (P=0.172 and P=0.9 respectively).
Conclusions :
Patients with glaucoma are more likely to have postoperative refractive surprise compared with the general population. This is seen in patients without visually significant comorbidities, which suggest glaucoma plays a role in refractive outcomes not accounted for by current IOL calculations. Of note, the increase in refractive surprise seen in glaucoma patients appears to be irrespective of glaucoma type.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.