November 13, 2012
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Refractive outcome may not rely on manual capsulorrhexis centration, circularity

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CHICAGO — Manual capsulorrhexis profiles did not correlate with the predictability of refractive outcomes, according to a study presented here.

“In recent years, there’s been a growth shift in patients’ expectations following cataract surgery, from visual rehabilitation to, increasingly, expectations of refractive results,” Mali Okada, MBBS, said at the joint meeting of the American Academy of Ophthalmology and Asia-Pacific Academy of Ophthalmology. “The introduction of femtosecond laser technology in particular has prompted renewed scrutiny of the traditional methods of manual continuous curvilinear capsulorrhexis.”

The prospective study included 113 eyes of 108 patients who underwent conventional cataract surgery. Slit lamp anterior segment photography was performed 3 weeks after surgery. Computer software was used to analyze capsulorrhexis parameters. Keratometry was used to measure preoperative astigmatism.

Study results showed that the mean circularity index of the capsulorrhexis was 0.83 mm and mean decentration was 0.25 mm. Mean capsulorrhexis diameter was 4.41.

After surgery, 70% of patients had refraction within 0.5 D of the targeted value; 90% were within 1 D. Mean postop spherical equivalent was 0.5 D.

Ninety percent of patients attained uncorrected visual acuity of 20/40 or better; all but one patient had best corrected visual acuity of 20/30 or better.

Data showed statistically insignificant associations between circularity, decentration and deviation from targeted spherical equivalent refraction, Okada said.

Disclosure: Okada has no relevant financial disclosures.