Refractive Outcomes and Anterior Chamber Depth after Cataract Surgery in Eyes with and without Previous Pars Plana Vitrectomy

Choice of intraocular lens calculation formula for cataract patients with prior pars plana vitrectomy

“…In this study, 12% to 20% of vitrectomized eyes had a PE greater than 1 D, which is consistent with previous findings in vitrectomized eyes (14.58% to 24.59%) and 4 times higher than that in patients with normal cataract (3% to 5%). 1,3,4,7 We observed that the Kane formula had the highest overall accuracy in this population, whereas the differences in prediction accuracy between the new formulas were clinically insignificant (MedAE = 0.36 to 0.40 D). Notably, patients with specific surgical or biometric characteristics may experience greater refractive PE despite the use of new formulas, primarily because of ELP prediction error (related to ocular structure altered by previous surgeries and IOL placement at the ciliary sulcus).…”

“…1,32 Direct use of traditional formulas should be avoided in vitrectomized eyes with an AL ≥26 mm because this would result in an apparent hyperopic PE, which is consistent with previous studies. 3,4 We recommend considering the effect of vitreous tamponade when selecting a formula for these patients. For long eyes with balanced salt solution tamponade, we suggest using the EVO or Holla-day1-WKn formula, whereas the SRK/T-WK1 formula can be used for long eyes with silicone oil tamponade.…”

“…1,2 However, patients who have undergone pars plana vitrectomy (PPV) present a challenge to refractive prediction, with almost 20% experiencing an unexpected refractive outcome. 3,4 Such outcomes are mainly attributed to the altered ocular anatomy that impedes accurate prediction of the effective lens position (ELP), in addition to higher risk of biometric measurement error, IOL tilt, and decentration. 5,6 Hence, further investigation is necessary to improve prediction accuracy and reduce the risk of refractive surprise in this population.…”

“…Studies have shown that new IOL formulas, which incorporate artificial intelligence and additional biometric variables, exhibit superior performance compared with traditional formulas in vitrectomized eyes. 3,4,[7][8][9] However, the optimal formula varies between studies, possibly due to relatively small sample sizes (61 to 211 eyes), patient heterogeneity, and the use of different ranking criteria. The performances of IOL calculation formulas in vitrectomized eyes different in vitreous tamponade, history of scleral buckling, and biometric characteristics are not yet fully understood.…”

Refractive outcome in combined phacovitrectomy: Anterior segment changes and corrective factor for IOL power calculation improvement

“…In this context, vitrectomy surgery may introduce potential modifications affecting postoperative refractive error, such as inaccurate axial length (AL) measurements, changes in anterior chamber depth (ACD), instability of the IOL location and substitution of vitreous with aqueous humour. 7 In particular, the predictability of final postoperative IOL plane position with reference to the corneal and retinal plane (effective lens position (ELP) and related parameters) is crucial to avoid inaccurate postoperative refractive outcomes. In fact, the error from the ELP prediction corresponds to about 42% of the total refractive prediction error.…”