The Refractive Change After Cataract Surgery in Patients With Acute Primary Angle Closure

Jong Eul Kim; Sang Woo Park

doi:10.3341/jkos.2009.50.11.1669

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Kim and Park: The Refractive Change After Cataract Surgery in Patients With Acute Primary Angle Closure

Original Article

J Korean Ophthalmol Soc 2009;50(11):1669-1673.

Published online: 31 August 2009

DOI: https://doi.org/10.3341/jkos.2009.50.11.1669

The Refractive Change After Cataract Surgery in Patients With Acute Primary Angle Closure

Jong Eul Kim, MD, Sang Woo Park, MD

Department of Ophthalmology, Chonnam National University Medical School, Gwangju, Korea

Address reprint requests to Sang Woo Park, MD, Department of Ophthalmology, Chonnam National University Medical School and Hospital #8 Hak-dong, Dong-gu, Gwangju 501-757, Korea Tel: 82-62-220-6743, Fax: 82-62-227-1642, E-mail: exo70@jnu.ac.kr

Received 10 February 2009 Accepted 28 July 2009

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 change of postoperative refraction after cataract surgery in patients with a history of acute primary angle closure.

Methods

A survey was conducted on 40 eyes of 40 patients who underwent cataract surgery with a history of acute primary angle closure, and 40 eyes of 40 patients who underwent cataract surgery only during the follow-up period of six months. We reviewed changes in the postoperative refraction and compared the difference between the postoperative spherical equivalent and target refraction in both groups.

Results

In the group with a history of acute primary angle closure, target refraction was −0.20±0.27D and the six months postoperative spherical equivalent was −0.76±1.12D. In the group with cataract only, target refraction was −0.30±0.20D and the six months postoperative spherical equivalent was −0.22±0.57D. In the group with the history of acute primary angle closure, the postoperative refraction shifted to myopic refractive power significantly.

Conclusions

In cataract patients with a history of acute primary angle closure, there was a myopic shift in postoperative refraction after cataract surgery. Therefore, this finding should be considered during cataract surgery.

Keywords: Acute primary angle closure, Cataract, Refraction

References

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Table 1.

Patient demographics including intraocular pressure and axial length

	Cataract with history of acute primary angle closure (n=40)	Cataract only (n=40)	p-value
Age	66.17±9.83	63.97±9.19	0.36^*
Sex (M: F)	21: 19	23: 17	0.65^*
Intraocular pressure (mm Hg)	16.84±3.12	15.35±3.66	0.54^†
Axial length (mm)	22.46±0.80	23.17±1.10	0.41^†

^*Chi-square test

^†Student t-test.

Table 2.

Anterior chamber depth, lens thickness and relative lens position

	Cataract with history of acute primary angle closure (n=40)	Cataract only (n=40)	p-value
Anterior chamber depth (mm)	1.72±0.33	3.02±0.34	<0.01^*
Lens thickness (mm)	5.25±0.25	4.50±0.21	<0.01^*
Relative lens position	0.19±0.01	0.23±0.03	<0.01^*

Relative lens position=ACD/AXL+(LT/AXL)/2

^*Student t-test.

Table 3.

Target refractive power and postoperative spherical equivalent of cataract with history of acute primary angle closure and cataract only

	Cataract with history of acute primary angle closure (n=40)	p-value	Cataract only	p-value
TR^* (D)	−0.20±0.27		−0.30±0.20
SE^† (D)	−0.18±1.17	0.93^∏	−0.18±0.81	0.37^∏
SE^‡ (D)	−0.69±1.14	<0.01^∏	−0.23±0.73	0.59^∏
SE^§ (D)	−0.76±1.12	<0.01^∏	−0.22±0.57	0.96^∏

^*TR=target refractive power

^†SE=spherical equivalent at 1 week after surgery

^‡SE=spherical equivalent at 1 month after surgery

^§SE=spherical equivalent at 6 months after surgery

^∏paired t-test.

Table 4.

Postoperative spherical equivalent difference from the target refractive power

	Cataract with history of acute primary angle closure (n=40)	Cataract only (n=40)	p-value
TR^* (D)	−0.20±0.27	−0.30±0.20	0.08^∏
SE^†-TR^* (D)	0.01±1.24	0.11±0.81	0.67^∏
SE^‡-TR^* (D)	−0.49±1.13	0.06±0.71	0.01^∏
SE^§-TR^* (D)	−0.56±1.18	−0.005±0.56	0.01^∏

^*TR=target refractive power

^†SE=spherical equivalent at 1 week after surgery

^‡SE=spherical equivalent at 1 month after surgery

^§SE=spherical equivalent at 6 months after surgery

^∏Student t-test.

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