J Korean Ophthalmol Soc > Volume 59(12); 2018 > Article
Journal of the Korean Ophthalmological Society 2018;59(12):1173-1180.
DOI: https://doi.org/10.3341/jkos.2018.59.12.1173    Published online December 15, 2018.
Refractive Error Induced by Combined Phacotrabeculectomy.
Jun Seok Lee, Chong Eun Lee, Ji Hae Park, Sam Seo, Kyoo Won Lee
1Cheil Eye Hospital, Daegu, Korea. vit.s0324@gmail.com
2Department of Ophthalmology, Keimyung University School of Medicine, Daegu, Korea.
섬유주절제술과 백내장 병합수술 후 굴절력 오차의 분석
이준석1⋅이종은2⋅박지혜1⋅서샘1⋅이규원1
제일안과병원1, 계명대학교 의과대학 안과학교실2
Correspondence:  Sam Seo,
Email: vit.s0324@gmail.com
Received: 5 July 2018   • Revised: 26 August 2018   • Accepted: 23 November 2018
Abstract
PURPOSE
We evaluated the postoperative accuracy of intraocular lens power prediction for patients undergoing phacotrabeculectomy and identified preoperative factors associated with refractive outcome in those with primary open-angle glaucoma (POAG). METHODS: We retrospectively reviewed the medical records of 27 patients who underwent phacotrabeculectomy to treat POAG. We recorded all discrepancies between predicted and actual postoperative refractions. We compared the data to those of an age- and sex-matched control group that underwent uncomplicated cataract surgery during the same time period. Preoperative factors associated with the mean absolute error (MAE) were identified via multivariate regression analyses. RESULTS: The mean refractive error of the 27 eyes that underwent phacotrabeculectomy was comparable to that of the 27 eyes treated via phacoemulsification (+0.02 vs. −0.01 D, p = 0.802). The phacotrabeculectomy group exhibited a significantly higher MAE (0.65 vs. 0.35 D, p = 0.035) and more postoperative astigmatism (−1.07 vs. −0.66 D, p = 0.020) than the phacoemulsification group. The preoperative anterior chamber depth (ACD) and the changes in the postoperative intraocular pressure (IOP) were significantly associated with a greater MAE after phacotrabeculectomy. CONCLUSIONS: POAG treatment via combined phacoemulsification/trabeculectomy was associated with greater error in terms of final refraction prediction, and more postoperative astigmatism. As both a shallow preoperative ACD and a greater postoperative change in IOP appear to increase the predictive error, these two factors should be considered when planning phacotrabeculectomy.
Key Words: Astigmatism;Glaucoma;Phacotrabeculectomy;Refractive outcome


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