Effect of Endocyclophotocoagulation on Refractive Outcomes in Patients With Primary Angle Closure Having Cataract Surgery

Tuesday, April 21, 2015: 1:46 PM
Room 5A (San Diego Convention Center)
Jay Ching Chieh Wang, MD
Manjool Shah, MD
Xavier Campos-Möller, MD
Moness Masri, MD
Arsham Sheybani, MD
Ike K. Ahmed, MD

To compare post-operative refractive outcomes between eyes with primary angle closure undergoing phacoemulsification and intraocular lens (IOL) implantation with and without endocyclophotocoagulation (ECP)

This is a retrospective chart review of patients undergoing phacoemulsification and IOL implantation with or without ECP. All patients had one of the following primary angle closure spectrum conditions pre-operatively: primary angle closure suspect, primary angle closure or primary angle closure glaucoma. Clinical data including axial length (AL), anterior chamber depth (ACD), corneal white-to-white (WTW) and refractive outcomes were collected. Mean of arithmetic (MArE) and absolute (MAE) refractive error was calculated for the Holladay 1 IOL calculation formula.

In total, 68 eyes with ECP and 69 eyes without ECP were included. Ocular parameters were: AL (ECP = 22.80±0.10mm vs non-ECP = 22.80±0.08mm, p=0.99), ACD (ECP = 2.65±0.36mm vs non-ECP = 2.63±0.28mm, p=0.68), and WTW (ECP = 11.89±0.39mm vs non-ECP = 11.83±0.43mm, p=0.40). MAE obtained from Holladay 1 formula was significantly lower in the non-ECP group (0.48±0.04D) compared to the ECP group (0.61±0.05D, p=0.049). Furthermore, MArE obtained through Holladay 1 formula was significantly lower in the ECP group (-0.52±0.07D) compared to the non-ECP group (-0.23±0.06D, p=0.001).

Our results suggest that in patients with angle-closure or shallow anterior chambers undergoing cataract extraction and IOL implantation, adjunctive ECP may lead to less predictability of postoperative refraction and could induce a slight myopic shift.