Abstract
Purpose :
Scleral buckle (SB) surgery for retinal detachment is associated with axial elongation, myopic shift, and induced astigmatism. There is a lack of research investigating the impact of these ocular changes on refractive predictability of cataract surgery. The purpose of this study was to investigate postoperative refractive outcomes of cataract surgery in patients with a prior history of SB surgery.
Methods :
In our retrospective consecutive case series, patients with a history of SB that underwent subsequent cataract surgery and a post-operative refraction between 21 and 365 days after surgery were included. Eyes with silicone oil at the time of pre-operative biometric measurements, previous incisional cornea surgery, or other coexisting ocular pathology. Predicted post-operative spherical equivalents were calculated with the Barrett Universal II formula for the implanted IOL.
Results :
37 eyes from 37 patients met the inclusion/exclusion criteria. Mean interval between SB and cataract extraction was 20.8 ± 28.3 months and mean age at the time of cataract extraction was 59.7 ± 10.2 years. While 3 patients had pre-operative axial length (AL) measured by ultrasound, 34 patients had AL measured by swept-source optical coherence tomography. Using the Barrett Universal II formula, mean prediction error and absolute prediction error were 0.09 ± 0.64 D and 0.49 ± 0.41 D, respectively. 64.9%, 81.1%, and 91.9% of eyes fell within 0.5, 0.75, and 1.0 D of predicted.
Conclusions :
In eyes with a history of scleral buckling that undergo subsequent cataract surgery, the mean prediction error of the Barrett Universal II formula is less than 0.1 D. However, these eyes may still experience poorer refractive outcomes than observed in surgery naïve eyes.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.