Improved accuracy of intraocular lens power calculation by preoperative management of dry eye disease

BMC Ophthalmol. 2021 Oct 13;21(1):364. doi: 10.1186/s12886-021-02129-5.

Abstract

Background: To evaluate the effects of pretreatment for dry eye disease (DED) on the accuracy of intraocular lens (IOL) power calculation.

Methods: Patients who underwent uneventful cataract surgery were included in the study. IOL power was determined using the SRK/T and Barrett Universal II (Barrett) formulas. The patients were divided into non-pretreatment and pretreatment groups, and those in the pretreatment group were treated with topical 0.5% loteprednol etabonate and 0.05% cyclosporin A for 2 weeks prior to cataract surgery. Ocular biometry was performed in all groups within 2 days before surgery. The mean prediction error, mean absolute error (MAE), and proportions of refractive surprise were compared between the non-pretreatment and pretreatment groups at 1 month postoperatively. Refractive surprise was defined as MAE ≥ 0.75D.

Results: In a total of 105 patients, 52 (52 eyes) were in the non-pretreatment group and 53 (53 eyes) in the pretreatment group. The MAE was 0.42 ± 0.33, 0.38 ± 0.34 (SRK/T, Barrett) and 0.23 ± 0.19, 0.24 ± 0.19 in the non-pretreatment and pretreatment groups, respectively (p < 0.001/=0.008). The number of refractive surprises was also significantly lower in the pretreatment group. [non-pretreatment/pretreatment: 9/2 (SRK/T); 8/1 (Barrett); p = 0.024/0.016]. Pretreatment of DED was related to a reduction in postoperative refractive surprise. [SRK/T/Barrett: OR = 0.18/0.17 (95% CI: 0.05-0.71/0.05-0.60), p = 0.014/0.006].

Conclusions: The accuracy of IOL power prediction can be increased by actively treating DED prior to cataract surgery.

Keywords: Cataract surgery; Dry eye; Intraocular lens power calculation; Preoperative treatment.

MeSH terms

  • Biometry
  • Dry Eye Syndromes*
  • Humans
  • Lens Implantation, Intraocular
  • Lenses, Intraocular*
  • Optics and Photonics
  • Phacoemulsification*
  • Refraction, Ocular
  • Retrospective Studies