The effects of peripheral anterior synechiae on refractive outcomes after cataract surgery in eyes with primary angle-closure disease

Abstract

Objective of the study was to investigate the effects of peripheral anterior synechiae (PAS) on refractive outcomes after cataract surgery in eyes with primary angle-closure disease (PACD). This is a retrospective, cross-sectional study. Seventy eyes of 70 PACD patients who underwent phacoemulsification and intraocular lens implantation. Patients were divided into 2 groups based on the presence of PAS on preoperative gonioscopy. The predictive power of the intraocular lens was calculated by the SRK/T, Hoffer Q, Haigis, and Holladay formulae. The mean absolute error (MAE) and predicted refractive errors were compared between PAS (+) and PAS (–) groups. We also evaluated the refractive errors with regards to the extent of PAS in the subanalyses. The mean MAE was greater in the PAS (+) group with all formulae (0.61–0.70 diopters [D] vs 0.33–0.45 D, all P < .05). The eyes with PAS tended towards myopia (−0.30 D to −0.51 D vs −0.05 D to +0.24 D, all P < .05). However, the MAEs or predicted refractive errors were not different, irrespective of the extent of PAS in the subanalyses (all, P > .05). The presence or absence of PAS may influence the postoperative refractive outcomes in PACD patients.

A systemic review and network meta-analysis of accuracy of intraocular lens power calculation formulas in primary angle-closure conditions

“…Consequently, discrepancies are unsurprising in IOL prediction in eyes with PACD. Additionally, currently available studies conducted among PACD eyes showed divergent accuracies of different formulas [7,9,21,[24][25][26]. All these facts stress the importance of our study.…”

“…synechial angle closure without/with glaucomatous neuropathy in the PACD spectrum (i.e., PAC, PACG). Though PACS was also mentioned in some studies [9], the fact that it did not strictly follow the ISGEO definition led to our exclusion of the data in case any bias were introduced. Furthermore, given that less than 1% of PACS would progress into PAC/PACG per year as stated by He et al [28] and that only 2.5~3.75% PACS ultimately develop PAC/PACG [29], PACS might be an independent subgroup different from PAC/PACG in view of pathogenesis and prognosis.…”

“…Along with well-accepted precision of ocular biometry, accuracy of manufacturer IOL power quality control and the now-mature surgical techniques, the accuracy of IOL power calculation becomes the most essential factor for achieving the target refraction post-operatively. A dozen formulas for IOL power calculation have been established with diverse core principles on the basis of normal eyes since 1980s, yet the accuracy varies [7][8][9]. Theoretically, it could be well imagined that discrepancies in IOL prediction would occur when these formulas, especially regressive ones [10], were applied to special population with unusual ocular biometric parameters, e.g., significantly shallow anterior chamber (AC), thick lens and short axial length (AL) [11][12][13].…”

Катарактасы Бар Науқастарға Офтальмологиялық Көмек Көрсетуді Ұйымдастыруды Оңтайландыру

“…Так, например, согласно многочисленным клиническим исследованиям и описаниям случаев и их серий, набухающая масса катаракты может привести к синехиям передней капсулы хрусталика со зрачковым краем радужки, что может блокировать отток внутриглазной жидкости с задней камеры глаза в переднюю [12][13][14]. Из-за подобного нарушения дренажной системы глаза, сдвинутая вперед радужная оболочка с сопутствующими пролиферативными процессами может привести к передним синехиям, в итоге закрывая доступ к трабекулярной формации, откуда происходит основной дренаж жидкости глаза [14,15]. К ряду осложнений можно так же отнести сублюксацию и дислокацию хрусталикового материала, увеиты, кератиты и другие воспалительные патологии [12,[16][17][18][19][20].…”

Comparison of intraocular lens power calculation formulas in patients with a history of acute primary angle-closure attack

“…In addition to the pupillary block factor, non-pupillary block factors such as plateau iris syndrome, lens-related factors, or retrolental factors may affect the APAC crisis. In most of the eyes, more than one mechanism may be involved in the pathogenesis of angle closure [1].…”