Refractive outcomes after phacovitrectomy surgery

Purpose: To evaluate the refractive accuracy of intraocular lens (IOL) power calculation after phacovitrectomy.

Setting: Eye Hospital Zonnestraal and Department of Ophthalmology Academic Medical Center, Amsterdam, the Netherlands.

Design: Retrospective comparative case series.

Methods: Refraction results 1 month after phacovitrectomy or phacoemulsification were compared with predicted refractions calculated using the IOLMaster 500 and the Haigis formula. Indications for vitrectomy were macular pucker, macular hole, vitreous floaters, vitreous hemorrhage, and vitreomacular traction. Enrolled eyes had an axial length (AL) between 20.13 mm and 29.43 mm.

Results: The phacovitrectomy group comprised 133 eyes (133 patients) and the phacoemulsification group, 132 eyes (132 patients). The refractive outcomes after phacovitrectomy (-0.06 diopter [D] ± 0.50 [SD]) and phacoemulsification (-0.08 ± 0.47 D) were comparable (P = .74). The final postoperative refraction was within ±1.00 D of the preoperative refractive target in 94.9% and 94.6% of phacovitrectomy cases and phacoemulsification cases, respectively. Subgroup analysis found no increased risk for refractive surprises after gas tamponade or in eyes with an AL of 26.00 mm or greater.

Conclusions: Standard IOL power calculation used in regular phacoemulsification surgery was accurate in phacovitrectomy procedures in eyes with a wide range of AL and a wide range of vitrectomy indications. No tendency toward a myopic shift was found.

Financial disclosure: Dr. Lapid-Gortzak is a clinical investigator for, speaker for, and consultant to Alcon Laboratories, Inc., Hanita Lenses, a speaker for Santen Pharmaceutical Co., and a consultant to Sanoculis and Orca Surgical. None of the authors has a financial or proprietary interest in any material or method mentioned.