EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/76185
July 2012 EW RESIDENTS 53 pre-op corneal astigmatism was identified as an independent risk factor for higher errors in biometry prediction. The current study shows that the majority of cataract surgery done in recent years aims for em- metropia, but this is only achieved in approximately two-thirds of cases. Despite various techniques to im- prove post-op refraction prediction, including the use of complex formu- las for various situations, this study clearly reveals that much work is still needed if we intend to more accurately predict results. However, the study has several weaknesses. First, this study is retro- spective in nature and would benefit from a similar study conducted in a prospective fashion. Second, the NCR represents approximately two- thirds of all cataract surgical centers in Sweden. It is unclear whether these sites disproportionately repre- sent more experienced surgeons who have undoubtedly modified their surgical practices to achieve desired outcomes (i.e., learned by trial and error) or less experienced surgeons who are still tailoring their skills. Third, the NCR database has limited information with less than half of cases having pre-op keratometry values and none having pre-op refractions recorded prior to first eye surgeries. As a result, several assumptions were made to reach some conclu- sions. For example, a sub-analysis of first eye surgeries revealed that myopic eyes become more myopic than planned, and hyperopic eyes become more hyperopic than planned. However, this is based on the assumption that "the refraction in the untouched fellow eye regis- tered post-operatively resembles the pre-operative refraction in the first eye," which certainly does not hold true in all cases. Furthermore, lack of details in the NCR on the type of biometric formula or other surgical strategies used to reduce pre-op corneal astigmatism makes it very difficult to critically analyze the authors' data. In summary, this article pro- vides good general data regarding intended versus actual refractive errors after cataract surgery. It demonstrates that while a majority of patients do obtain near the intended refractive outcome, IOL calculation formulas are not perfect. The above-mentioned limitations make critical analysis difficult, espe- cially as no data is available on the type of formula used. Further analysis with particular attention to pre- and post-op refraction and keratometry as well as type of biometric formula used would prove to be very useful. EW Contact information Pruett: paul.pruett@emory.edu Make Plans Now to Attend 2013 ASCRS•ASOA Specialty Meetings Make the most of your time in San Francisco next April by attending either of our specialty programs. Each offers focused information on key subspecialties that affect nearly all ophthalmic practices. Sponsored by the Cornea Society and ASCRS. The 2013 Cornea Day is geared toward practicing ophthalmologists with an interest in comprehensive ophthalmology, anterior segment surgery, and corneal disease. For registration, housing and program updates go to... www.CorneaDay.org Pressure is important, but don't lose sight of the vision! Presenting glaucoma treatment in a cataract and refractive context. Join us for glaucoma pearls and updates to enhance your practice. For registration, housing and program updates go to... www.ASCRSGlaucomaDay.org These activities has been approved for AMA PRA category 1 credit.TM