Optical biometry in combined phacovitrectomy

Purpose

To assess the accuracy of intraocular lens (IOL) power calculation using optical biometry in patients having combined phacovitrectomy for macular hole and macular pucker.

Setting

Sunderland Eye Infirmary, North East England, United Kingdom.

Methods

This single-surgeon retrospective case series review comprised eyes having combined narrow-gauge phacovitrectomy for macular hole or macular pucker. Intraocular lens power was calculated using the results of optical biometry and the Haigis formula. Achieved and planned refraction were compared to calculate the mean postoperative refractive prediction error (ME) and the mean absolute postoperative prediction error (MAE) and the percentage of eyes with an achieved refraction within ±0.50 diopter (D) and ±1.00 D of the planned refraction. The results were compared with those in a series of 42 eyes that had phacoemulsification after previous vitrectomy surgery and a series of 60 nonvitrectomized eyes that had uneventful phacoemulsification.

Results

Of the of 59 having combined phacovitrectomy, 39 had macular hole and 20 had macular pucker. There was no statistically significant difference in refractive outcomes between the phacovitrectomy group (ME –0.02, MAE 0.39) and the sequential phacoemulsification group (ME –0.10, MAE 0.38) (P = .82). There was a statistically significant difference between the phacovitrectomy group and the phacoemulsification-only group (ME 0.08, MAE 0.26) (P<.001).

Conclusions

The use of optical noncontact biometry with the Haigis formula achieved a high degree of accuracy of IOL power estimation in patients having phacovitrectomy. There was no tendency toward a myopic shift, as has been reported using ultrasound axial length measurement.