Second-Eye Refractive Error Depending on the Reflection Rate of First-Eye Refractive Error in Cataract Surgeries

Doo Ri Eo; Dong Hui Lim; Joo Hyun; Jae Hwan Choi; Min Gyu Lee; Eui Sang Chung; Tae Young Chung

doi:10.3341/jkos.2016.57.3.399

Journal List > J Korean Ophthalmol Soc > v.57(3) > 1010525

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Eo, Lim, Hyun, Choi, Lee, Chung, and Chung: Second-Eye Refractive Error Depending on the Reflection Rate of First-Eye Refractive Error in Cataract Surgeries

Original Article

J Korean Ophthalmol Soc 2016;57(3):399-404.

Published online: 3 September 2016

DOI: https://doi.org/10.3341/jkos.2016.57.3.399

Second-Eye Refractive Error Depending on the Reflection Rate of First-Eye Refractive Error in Cataract Surgeries

Doo Ri Eo, MD, Dong Hui Lim, MD, Joo Hyun, MD, Jae Hwan Choi, MD, Min Gyu Lee, MD, Eui Sang Chung, MD, PhD, Tae Young Chung, MD, PhD

Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

Address reprint requests to Tae Young Chung, MD, PhD, Department of Ophthalmology, Samsung Medical Center, #81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea, Tel: 82-2-3410-3563, Fax: 82-2-3410-0074, E-mail: tychung@skku.edu

Received 10 September 2015 Revised 29 September 2015 Accepted 9 December 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the reflection rate of the first eye in order to minimize the real refractive error in the second eye in bilateral consecutive cataract surgeries.

Methods

A retrospective analysis was performed with 248 patients who underwent bilateral sequential uncomplicated phacoemulsification and posterior chamber intraocular lens implantation. Predicted spherical equivalent was compared with postoperative spherical equivalent, and the range of real refractive error was analyzed by calculating the reflection rate of the first eye.

Results

When the difference between predicted spherical equivalent and postoperative spherical equivalent was greater than 0.5 D as calculated with the formula of Sanders-Retzlaff-Kraff Theoretical (SRK)-T and SRK II, application of 50-60%, 40-50% of the difference of the first eye was high probability to reduce the second-eye real refractive error (75%, 100%).

Conclusions

Application of 40-60% of the real refractive error in the first-eye can minimize the real refractive error in the second-eye in bilateral sequential cataract surgeries.

Keywords: Bilateral consecutive cataract surgery, Reflection rate, Refractive error

References

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Table 1.

Demographics and clinical characteristics (N = 248)

Characteristics	First-eye	Second-eye	p-value^*
Age (years)	67.10 ± 10.64 (19-86)
Sex (male/female)	139/109
Axial length (mm)	24.17 ± 1.97 (21.17, 34.10)	24.04 ± 1.78 (21.06, 33.47)	0.43
Anterior chamber depth (mm)	3.16 ± 0.46 (2.05, 5.51)	3.18 ± 0.44 (1.68, 4.38)	0.71
Average K (D)	43.88 ± 1.99 (22.48, 48.57)	43.73 ± 2.61 (23.94, 48.01)	0.48
Preoperative BCVA	0.64 ± 0.28 (0.01, 1.0)	0.68 ± 0.24 (0.02, 1.0)	0.20
Postoperative BCVA	0.91 ± 0.18 (0.05, 1.0)	0.90 ± 0.17 (0.03, 1.0)	0.73
Preoperative SE (D)	−1.07 ± 3.94 (-23.0, +6.75)	−0.80 ± 3.34 (-17.5, +6.25)	0.43
Postoperative SE (D)	−0.36 ± 0.88 (-7.25, +1.50)	−0.35 ± 0.82 (-4.63, +1.38)	0.88

Values are presented as mean ± SD (Min, Max) unless otherwise indicated.

SD = standard deviation; Min = minimum; Max = maximum; K = keratometry; D = diopter; BCVA = best corrected visual acuity (decimal value); SE = spherical equivalent.

^* The values of the first eye were compared with those of the second eye (independent t-test).

Table 2.

Accuracy of reflection rate in patients whose |RE1| > 0.5 D

	Reflection rate	0-10%	10-20%	20-30%	30-40%	40-50%	50-60%	60-70%	70-80%	80-90%	90-100%
SRK-T (N = 62)	Percent of \|RE2\| ≤ 0.5 D (%)	55	25	46	50	60	75	60	50	50	60
	Percent of \|RE2\| ≤ 1.0 D (%)	100	75	77	100	100	100	60	100	100	80
SRK II (N = 92)	Percent of \|RE2\| ≤ 0.5 D (%)	31	33	9	13	100	73	67	75	75	21
	Percent of \|RE2\| ≤ 1.0 D (%)	69	63	75	88	100	88	100	100	75	79

RE1 = first-eye real refractive error; RE2 = second-eye real refractive error; SRK = Sanders-Retzlaff-Kraff; T = theoretical.

Table 3.

Comparison of parameters in patients whose |RE1| > 0.5 D

	N	\|RE2\| ≤ 0.5 D	N	\|RE2\| > 0.5 D	p-value^*
SRK-T (N = 62)	31		31
Average K (D)		43.95 ± 1.37		43.31 ± 1.75	0.12
AXL (mm)		23.00 ± 6.47		24.42 ± 5.46	0.35
ACD (mm)		3.25 ± 0.45		3.31 ± 0.51	0.65
RE1 (D)		−0.01 ± 1.54		1.52 ± 5.39	0.13
\|RE1\| (D)		1.03 ± 1.13		1.85 ± 5.28	0.40
Reflection rate (%)		41.34 ± 33.04		34.65 ± 26.27	0.38
SRK II (N = 92)	32		60
Average K (D)		44.09 ± 1.71		44.00 ± 1.64	0.80
AXL (mm)		22.41 ± 6.06		24.08 ± 5.12	0.17
ACD (mm)		3.15 ± 0.49		3.32 ± 0.46	0.12
RE1 (D)		−0.06 ± 0.99		−0.03 ± 1.57	0.92
\|RE1\| (D)		0.91 ± 0.40		1.13 ± 1.08	0.28
Reflection rate (%)		47.20 ± 36.95		34.34 ± 32.28	0.09

Values are presented as mean ± SD unless otherwise indicated.

RE1 = first-eye real refractive error; RE2 = second-eye real refractive error; SRK = Sanders-Retzlaff-Kraff; T = theoretical; K = keratometry; D = diopter; AXL=axial length; ACD = anterior chamber depth; SD = standard deviation.

^* The values were compared by independent t-test.

Table 4.

Accuracy of IOL formula in patients whose |RE1| > 0.5 D

	IOL formula of 1st surgery	\|RE2\| (D)	RE2 (D)
SRK-T (N = 62)	SRK II	0.82 ± 0.88	0.27 ± 1.17
	SRK-T	0.66 ± 0.65	0.29 ± 0.88
SRK II (N = 92)	SRK II	0.82 ± 0.77	0.05 ± 1.13
	SRK-T	0.54 ± 0.58	0.19 ± 0.77

Values are presented as mean ± SD.

IOL = intraocular lens; RE1 = first-eye real refractive error; RE2 = second-eye real refractive error; D = diopter; SRK = Sanders-Retzlaff-Kraff; T = theoretical; SD = standard deviation.

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