Influence of the prediction error of the first eye undergoing cataract surgery on the refractive outcome of the fellow eye

Abstract

Ludmilla Gorodezky,1,2 Babac AE Mazinani,2 Niklas Plange,2 Peter Walter,2 Martin Wenzel,1 Gernot Roessler2 1Petrisberg Eye Clinic, Trier, Germany; 2Department of Ophthalmology, RWTH Technical University of Aachen, Aachen, Germany Introduction: In addition to measurement errors, individual anatomical conditions could be made responsible for unexpected prediction errors in the determination of the correct intraocular lens power for cataract surgery. Obviously, such anatomical conditions might be relevant for both eyes. The purpose of this study was to evaluate whether the postoperative refractive error of the first eye has to be taken in account for the biometry of the second. Methods: In this retrospective study, we included 670 eyes of 335 patients who underwent phacoemulsification and implantation of a foldable intraocular lens in both eyes. According to the SRK/T formula, the postoperative refractive error of each eye was determined and compared with its fellow eye. Results: Of 670 eyes, 622 showed a postoperative refractive error within ±1.0 D (93%), whereas the prediction error was 0.5 D or less in 491 eyes (73%). The postoperative difference between both eyes was within 0.5 D in 71% and within 1.0 D in 93% of the eyes. Comparing the prediction error of an eye and its fellow eye, the error of the fellow eye was about half the value of the other. Conclusion: Our results imply that substitution of half of the prediction error of the first eye into the calculation of the second eye may be useful to reduce the prediction error in the second eye. However, prospective studies should be initiated to demonstrate an improved accuracy for the second eye’s intraocular lens power calculation by partial adjustment. Keywords: cataract surgery, biometry, IOL power calculation, refractive error, fellow eye