Effect of Prior Refractive Surgery on Timing of Cataract Surgery

Tuesday, April 21, 2015: 1:06 PM
Room 4 (San Diego Convention Center)
Nilufer Yesilirmak, MD
Priyanka Chhadva, BS
Daniel Waren, MSPH
Kendall E. Donaldson, MD, MS

To investigate the timing of cataract extraction in patients with a history of prior corneal refractive surgery (LASIK/PRK) and to compare with a group of age-matched controls.  To compare the visual acuity (BCVA) at the time of cataract evaluation between both groups to determine if these patients are potentially more sensitive to changes in vision (reflecting higher visual demands).  To assess whether LASIK influences timing of subsequent cataract surgery.

Age and surgical history were captured on 436 cases of cataract surgery from September 2013 to September 2014. 25 cataract patients (5.7%) had a prior history of LASIK/PRK surgery (LASIK group) and 411 age-related cataract patients (94.3%) had no history of LASIK/PRK (non-LASIK group).

The non-LASIK group had an average age of 69.34 ± 11.19 years while the LASIK Group had an average age of 62.96 ± 7.64 years. The difference between these two groups is statistically significant (t(434), 2.811, p=0.005). The non-LASIK group had a pre-op BCVA of 0.326 ± .314 (20/42) and the LASIK group had a pre-op BCVA of 0.299 ± .160 (20/40). The pre-op BCVA for these two groups was not statistically significantly different (t(238),0.283, p=0.777).

Cataract progression after LASIK is not very rapid but significantly earlier then age related cataract progression. Since pre-op BCVA of both groups are not significantly different, hypothesized increased sensitivity to visual decline in post-LASIK patients is eliminated in the interpretation of the results. The mechanism of the effect of LASIK on lens status remains unclear.