Accuracy of preoperative biometry in vitrectomy combined with cataract surgery for patients with epiretinal membranes and macular holes: results of a prospective controlled clinical trial.
OBJECTIVE
To evaluate how adding vitrectomy to cataract surgery affects the accuracy of preoperative biometry and postoperative refractive outcomes.


METHODS
Department of Ophthalmology, Ludwig Boltzmann Institute of Retinology and Biomicroscopic Lasersurgery, Rudolf Foundation Clinic, Vienna, Austria.


METHODS
This study comprised 40 patients with vitreoretinal pathology and coexisting significant cataract (study group) and 40 patients with significant cataract only (control group). The main outcome measure was intraocular lens (IOL) power prediction error. Secondary outcome measures were spherical equivalent, anterior chamber depth, axial length, keratometry values, and intraocular pressure. A multivariate regression analysis was performed.


RESULTS
There was a significant difference in prediction error between the study group and control group (P< .05). The addition of vitrectomy was associated with induced myopia of approximately -0.4 diopter, more so in patients who had epiretinal membrane removal than in patients with macular hole surgery (P= .04). There was no significant difference in prediction error between the 3 IOLs used (P= .2).


CONCLUSIONS
The myopic shift was strongly dependent on the diagnosis and the need for intraocular tamponade, indicating that a slightly hyperopic IOL should be used in patients having combined surgery.
Falkner-Radler
Christiane I
CI
Department of Ophthalmology, Ludwig Boltzmann Institute of Retinology and Biomicroscopic Lasersurgery, Rudolf Foundation Clinic, Vienna, Austria. christiane.falkner-radler@wienkav.at
Benesch
Thomas
T
Binder
Susanne
S
D000368:Aged; D000369:Aged, 80 and over; D001699:Biometry; D002386:Cataract / Q000150:complications; D019773:Epiretinal Membrane / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000209:etiology*; D018918:Phacoemulsification; D011300:Preoperative Care; D011446:Prospective Studies; D012029:Refraction, Ocular; D015203:Reproducibility of Results; D012167:Retinal Perforations / Q000150:complications / Q000601:surgery*; D014792:Visual Acuity; D014821:Vitrectomy / Q000009:adverse effects*