Purpose: To analyze the refractive error in highly myopic eyes after cataract surgery and investigate the possible impact of fixation stability on it.
Design: Secondary data analysis from a previous prospective study.
Methods: Clinical data of 98 eyes of 98 consecutive patients with high myopia and 42 eyes of 42 controls, which underwent cataract surgery, were analyzed. Refractive error was calculated 1 month after surgery based on both Sanders-Retzlaff-Kraff theoretic (SRK/T) and Holladay 1 formulas. Fixation stability was evaluated using the Macular Integrity Assessment microperimeter system, which assessed the fixation pattern in terms of 63% and 95% of the bivariate contour ellipse area (BCEA). Multiple linear regression analysis was performed to identify independent predictors of postoperative refractive error.
Results: The highly myopic cataract group had greater hyperopic refractive errors (P < .001 for both formulas) and larger 63% and 95% BCEA values (P = .033 and P = .034) than the control group. In the highly myopic group, the factors 63% or 95% BCEA were positively correlated with the postoperative refractive error (SRK/T formula, r = 0.383, P < .001 and r = 0.320, P = .002, respectively). Multiple linear regression analysis showed that with the SRK/T formula, postoperative refractive error in highly myopic eyes was significantly correlated with axial length (β = 0.491, P < .001), 63% BCEA (β = 0.181, P = .045), and corneal curvature (β = -0.190, P = .024). The refractive error was no longer associated with corneal curvature after using the Holladay 1 formula.
Conclusions: Highly myopic eyes usually had hyperopic refractive errors after cataract surgery. Fixation stability might serve as an important determinant of postoperative refractive errors in this population.
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