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Trabectome-phaco yields less refractive precision than phaco alone
FORT LAUDERDALE, Fla. — Combined Trabectome surgery and phacoemulsification yielded unforeseen refractive changes that were not predicted by current IOL calculation techniques, according to a scientific poster presented here.
The retrospective study, presented by Douglas J. Rhee, MD, and colleagues at the American Glaucoma Society meeting, included 50 patients with primary open-angle glaucoma; 34 patients underwent combined phacoemulsification and Trabectome (NeoMedix) surgery, and 16 patients underwent phacoemulsification alone.
The Holladay II IOL calculation formula was used to target refractive outcomes.
The accuracy of refractive outcomes was calculated by preoperative predicted refractive outcomes with spherical equivalent and manifest refraction at 1 month after surgery.
Significantly less precise refractive outcomes were seen in the combined group compared with the phacoemulsification-only group (P = .01).
Phacoemulsification-Trabectome surgery yielded a slightly hyperopic average deviation (0.11 D). Patients in the phacoemulsification-alone group had a slightly myopic deviation (0.09 D), which was not statistically significant.
Deviation from target refraction varied 0.5 D in the combined group and 0.12 D in the phacoemulsification-only group.
“On one hand, the trend we observed towards an average hyperopic shift in phaco-Trabectome patients suggests a posterior shift in lens position,” the authors wrote. “However, this trend was not statistically significant, and our patients with myopic shifts suggest that not all eyes are affected the same way. If the lens-iris diaphragm is in fact shifting, it may not always be in the posterior direction.” – by Matt Hasson and Patricia Nale, ELS
Disclosure: Rhee reports he receives grant support from Allergan, Glaukos, Merck and Ivantis and is a consultant for Aerie, Alcon and Sanofi.