Abstract
Purpose :
The purpose was to compare pre-operative refractive target to post-operative refraction in patients with acute angle closure glaucoma (ACG) who underwent cataract surgery. We also assessed whether peripheral anterior synechiae (PAS), lens thickness (LT), anterior chamber depth (ACD), or time between angle closure and cataract surgery were associated with greater discrepancy in refractive outcomes.
Methods :
This was a retrospective chart review of 16 eyes with ACG who underwent cataract extraction and intraocular lens placement at Northwell Health. ACD and LT were obtained via the IOL Master. A Pearson correlation test was used to analyze the correlation between ACD and the difference between pre-operative refractive target and true refractive outcome following surgery in spherical equivalents (ΔR). A Pearson correlation test was also used to assess the correlation between LT and ΔR, and between days from angle closure to surgery and ΔR. A t-test was used to compare refractive outcomes and ΔR in patients with no PAS (n=8) vs PAS and to compare ΔR in patients with ACD ≥2mm (n=8) vs ACD <2mm.
Results :
Our patient population was 56% female with an average ACD of 2.16mm and an average LT of 5.26mm. Target refraction was emmetropia for all patients except one, who was -1.25. Average difference between pre-operative refractive target and true refractive outcome (ΔR) was -0.48. There was a statistically significant difference in the mean spherical equivalent outcome in patients with PAS vs. those with no PAS (0.18 vs -1.05; p=0.05). 3 of 16 eyes had hyperopic outcomes and all 3 of those patients were in the PAS group. The difference in ΔR between patients with PAS vs. no PAS was not statistically significant (0.18 vs -0.89; p=0.09). The difference in ΔR between patients with ACD <2mm vs. ACD ≥2mm was also not statistically significant (-0.06 vs -1.15; p=0.09). There was no statistically significant correlation between ΔR and the number of days from angle closure to cataract surgery, LT or ACD.
Conclusions :
Patients with PAS in the setting of acute angle closure glaucoma may be more likely to have a hyperopic refraction following cataract surgery. Patients with PAS and patients with ACD <2mm trended towards a more positive ΔR, however these findings were not statistically significant. There was no correlation between ΔR and the number of days from angle closure to cataract surgery, LT or ACD in this patient population.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.