title: Anterior segment configuration as a predictive factor for refractive outcome after cataract surgery in patients with glaucoma.
abstract: BACKGROUND
  To compare refractive outcomes after cataract surgery between patients with closed-angle and open-angle glaucoma and evaluate the influence of preoperative factors on refractive outcomes in patients with glaucoma.
  
  
  METHODS
  Patients diagnosed with glaucoma and who underwent uncomplicated cataract surgery were enrolled in this retrospective observational study. We collected data including age, history of prior laser peripheral iridotomy and trabeculectomy, type of glaucoma, manifest refraction, intraocular pressure, axial length, and various anterior segment parameters using anterior-segment optical coherence tomography. Factors associated with unsatisfactory refractive outcome at postoperative 6 month were evaluated.
  
  
  RESULTS
  A total of 143 eyes (143 subjects) were included. Of these, 49 and 94 had closed-angle and open-angle glaucoma, respectively. At postoperative-6 month evaluation, the mean absolute error (MAE) predicted by the SRK-II and SRK-T formulae was 0.67 ± 0.61 and 0.81 ± 0.66 diopters (D), respectively. The overall predictability of achieving within ± 1.0 D of target was 76.92 % and 72.73 %, respectively. At a cutoff value of 1.0 D for MAE, there was no statistical significant difference in refractive outcome between the closed-angle and open-angle glaucoma groups. Logistic regression modeling showed that large lens vault (LV) was a significant predictor of unsatisfactory refractive outcome after cataract surgery in patients with glaucoma.
  
  
  CONCLUSIONS
  When considering cataract surgery in patients with glaucoma, surgeons should recognize that the refractive outcomes may be unsatisfactory in eyes with large LV.
authors.affiliation: Department of Medical Science Graduate School, Chonnam National University, Gwangju, Republic of Korea.
authors.forename: Young Cheong
authors.initials: YC
authors.lastname: Kim
authors.affiliation: Department of Ophthalmology and Research Institute of Medical Sciences, Chonnam National University Medical School and Hospital, 42 Jebong-ro, Dong-gu, Gwangju, 61469, Republic of Korea.
authors.forename: Mi Sun
authors.initials: MS
authors.lastname: Sung
authors.affiliation: Department of Ophthalmology and Research Institute of Medical Sciences, Chonnam National University Medical School and Hospital, 42 Jebong-ro, Dong-gu, Gwangju, 61469, Republic of Korea.
authors.forename: Hwan
authors.initials: H
authors.lastname: Heo
authors.affiliation: Department of Ophthalmology and Research Institute of Medical Sciences, Chonnam National University Medical School and Hospital, 42 Jebong-ro, Dong-gu, Gwangju, 61469, Republic of Korea. exo70@naver.com.|Center for Creative Biomedical Scientists, Chonnam National University, Gwangju, Republic of Korea. exo70@naver.com.
authors.forename: Sang Woo
authors.initials: SW
authors.lastname: Park
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000869:Anterior Eye Segment / Q000473:pathology*; D058452:Axial Length, Eye / Q000502:physiology; D002387:Cataract Extraction; D005260:Female; D015812:Glaucoma, Angle-Closure / Q000503:physiopathology / Q000601:surgery*; D005902:Glaucoma, Open-Angle / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D019654:Lens Implantation, Intraocular; D007908:Lens, Crystalline; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012029:Refraction, Ocular / Q000502:physiology*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity
keywords: Anterior segment configuration; Cataract surgery; Lens vault; Refractive outcome