Refractive changes after vitrectomy and phacovitrectomy for macular hole and epiretinal membrane

Abstract

Neither author has a financial or proprietary interest in any material or method mentioned.

Changes in Anterior Chamber Depth after Combined Phacovitrectomy

“…13 According to another study, an even larger increase in ACD occured after phacovitrectomy and the IOL tended to be placed more posteriorly. 14 In contrast, Hamoudi and La Cour 3 observed that after phacovitrectomy, posterior capsule fibrosis was more severe than in cataract surgery alone, and that this caused the ELP to move anteriorly. Suzuki et al 5 found that using intraocular gas tamponade shifted the ELP forward, resulting in a change toward myopia.…”

“…2 One of the drawbacks of phacovitrectomy is deviations in the refractive outcomes. 3 The literature contains varied results, but myopic shift has been most commonly reported after phacovitrectomy. 4,5,6 Errors in axial length measurement, changes in anterior chamber depth (ACD), and aqueous humour replacing the vitreous all affect the refractive index and lead to myopic shift.…”

“…4,5,6 Errors in axial length measurement, changes in anterior chamber depth (ACD), and aqueous humour replacing the vitreous all affect the refractive index and lead to myopic shift. 3 ACD determines the effective lens position (ELP), which is an important factor in modern intraocular lens (IOL) power calculation formulas. Every 1 mm change in ELP results in 1.5 diopters (D) of deviation.…”

Refractive Outcomes Using the Lenstar Optical Low Coherence Reflectometry Biometer in Phacovitrectomy for Epiretrinal Membranes and Macular Holes

“…Removal of the vitreous gel may alter the ocular refractive index [12] and this has been calculated to contribute from −0.13D to −0.5D in myopic shift [6] [13] [14]. Vitrectomy may also influence the effective lens position and hence refractive outcome.…”

Clinical Aspects of Phacovitrectomy Complications

“…В большинстве случаев сообща-ется об отрицательной (миопической) рефракционной ошибке. Ее объясняют самыми разными факторами: погрешностью биометрии при измерении аксиальной длины глаза, изменением эффективного положения ИОЛ, неправильным выбором модели ИОЛ и формулы для определения оптической силы ИОЛ, тампонадой по-лости стекловидного тела газовой смесью, изменением индексов кератометрии, вкладом разновидности маку-лярной патологии [25,27,28].…”