Risk factors for refractive error after cataract surgery: Analysis of 282 811 cataract extractions reported to the European Registry of Quality Outcomes for cataract and refractive surgery

Abstract

Several risk factors (poor preoperative CDVA, ocular comorbidity, and previous eye surgery) were related to poor refractive outcomes after cataract extraction. When these risk factors are present, care should be taken with the preoperative examination and choice of IOL to avoid a refractive surprise. The average outcomes can be used as a refractive outcome benchmark.

Visual and Refractive Outcomes of Cataract Surgeries Performed in One Year in a Private Practice Setting: Review of 2714 Procedures

“…Patients included in our study were slightly younger, mean of 70.42 years, than those included in the 2013 (mean 73.9 years) and 2018 (mean 73.5 years) EUREQUO reports [6,7], with a majority of women. e percentage of eyes with prior pathologies and preoperative conditions increasing the surgical complexity (28.55% and 11.1% respectively) was similar in our study to those in the previous reports [6,9,10].…”

“…As regards refractive outcomes, our results also compare favorably with the recent reports. Mean absolute error between target and postoperative spherical equivalent was [21], and the EUROQUO report on refractive outcomes including surgeries performed in 2014 and 2015 found a mean absolute biometry prediction error of 0.42 D (SD 0.52) and 72.7% of eyes within 0.5 D of target [7]. Patients implanted with multifocal IOLs expect to be spectacle independent, and in order to achieve this and to optimize IOL performance, postoperative refraction should be close to emmetropia.…”

“…e advances in data collection and analyses have led to the creation of several registries, such as the European Registry of Quality Outcomes for Cataract and Refractive Surgery (EUREQUO) and the American Academy of Ophthalmology Intelligent Research in Sight (IRIS) Registry. Landmark studies have been the EUREQUO report on the results of 368 256 cataracts performed in 15 European countries [6], the EUROQUO report focused on refractive outcomes in 282 811 procedures [7], or the more recent IRIS report on the rates of endophthalmitis in 8 542 838 cataract surgeries performed in the United States [8]. However, most of the cases included in these registries do not come from private practice settings and patient characteristics, and expected outcomes may be different.…”

Prediction Accuracy of Total Keratometry Compared to Standard Keratometry Using Different Intraocular Lens Power Formulas

“…ecently, a large multinational database study on intraocular lens (IOL) predictability including 282,811 cases showed that the mean absolute spherical equivalent (SE) prediction error after cataract surgery was 0.42 diopters (D) and 72% of eyes were within ±0.50 D of predicted SE. 1 In addition to various factors, such as coexisting eye diseases and surgical complications, the authors stated that the influence of postoperative residual astigmatism was considerable in their study. 1 Although toric intraocular lenses (IOLs) are a major advance in compensating corneal astigmatism in the course of cataract surgery, residual postoperative astigmatism remains a concern, with more than one-third of patients not reaching the targeted refraction after toric IOL implantation.…”

The Effect of Multiple Variables on the Refractive Error After Cataract Surgery

“…So zdokonaľovaním techniky operácií a biometrických metód sme sa výrazné posunuli oproti prvej Ridleyho šošovky. Viac ako 90% operovaných očí dosahuje pooperačnú refrakciu (udanej v sférickom ekvivalente) v rozmedzí +/-1 D [2]. Na celkový výsledok operácie katarakty vplýva mnoho faktorov.…”