Importance of Corneal Spherical Aberration on Refractive Outcomes in Cataract Patients With Post-Myopic Refractive Surgery

Monday, April 20, 2015: 8:56 AM
Room 5A (San Diego Convention Center)
Young-sik Yoo, MD
Woong-Joo Whang, MD
Kyung-Sun Na, MD, PhD
So-Hyang Chung, MD, PhD
Hyi-Jin Kim, MS
Geunyoung Yoon, PhD
Choun-Ki Joo, MD

Our strategy is based on the observation that post-refractive surgery cataract surgery patients have substantially larger magnitude of corneal spherical aberration than normal cataract surgery. So we propose the hypothesis that corneal spherical aberration affects optimal intraocular lens (IOL) power significantly.

This study included 137 eyes who had a cataract surgery in our clinic from January 2010 to December 2013. They had received a refractory surgery for correcting myopia before 2005. Data were collected from patients’ medical records retrospectively. For the additional analysis, 50 patients who had not received refractive surgery were included as a control group. Patients who had another ocular disease or surgical history on eyes were excluded in this study.

Mean absolute error (MAE) and corneal spherical aberration (SA) of post-myopic refractive surgery group increased more than normal group. (p<0.05) There was any strong correlation between IOL power error and pre-operative SA overall. Expected lens position (ELP) error masked the effect of spherical aberration on IOL power error verifying from the result of very poor correlation between ELP and postoperative anterior chamber depth (ACD). After isolating ELP error by using optical ray tracing, the correlation between IOL power error and pre-operative SA was more clear.

Corneal spherical aberration has the significant influence on refractive outcomes of cataract surgery especially in patients with prior laser refractive surgery, thus needs to be taken into consideration in IOL power calculation.