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An Inter-eye Comparison of Refractive Outcomes Following Cataract Surgery

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PURPOSE

To investigate how the refractive outcomes of pairs of eyes are related. Previous evidence suggests altering intraocular lens (IOL) power for the second eye based on the refractive outcomes of the first eye following cataract surgery, which may not be the correct approach to improve second-eye outcome.

METHODS

Retrospective chart review of patients who underwent bilateral cataract surgery during the preceding 12 months was performed, from which 81 patients were recruited. The difference between postoperative refractive error and preoperative target refraction for both eyes was established. The relationship between pairs of eyes was analyzed.

RESULTS

The difference from target refraction and postoperative refractive error was statistically significantly correlated between pairs of eyes (t=3.02; P=.003); however, only 10% of the variability in the difference from target refraction for the second eye could be accounted for by the first eye. Even if only the direction of this difference was considered (more myopic or hypermetropic than target refraction), there was concordance between pairs of eyes 63% of the time. This relationship was not modified by age, sex, keratometry, biometry (anterior chamber depth or axial length), or IOL type.

CONCLUSIONS

The data suggest that each eye of an individual patient be considered independently when selecting IOL power as part of cataract surgery. [J Refract Surg. 2010;26:197-200.]

doi:10.3928/1081597X-20100224-06

AUTHORS

From South Australian Institute of Ophthalmology, The Queen Elizabeth Hospital, University of Adelaide, Woodville South, South Australia.

The authors have no proprietary or financial interest in the materials presented herein.

The authors thank Drs Arthur Karagiannis, Peter Cooper, Darcy Economos, and Neil Gehling, who performed the surgeries for this study, and the staff at The Queen Elizabeth Hospital for their support and assistance.

Correspondence: John Landers, MBBS, MPH, PhD, The Queen Elizabeth Hospital, 28 Woodville Rd, Woodville South, South Australia 5011. Tel: 618

8222 7579; Fax: 618 8222 6233; E-mail: john.landers@bigpond.com

Received: October 9, 2008; Accepted: April 2, 2009

Posted online: May 8, 2009