Accuracy of Intraocular Lens Power Estimation in Eyes Having Phacovitrectomy for Rhegmatogenous Retinal Detachment

Purpose: To evaluate the accuracy of intraocular lens power estimation in eyes having phacovitrectomy for rhegmatogenous retinal detachment.

Methods: Retrospective case review of 100 consecutive eyes that underwent phacovitrectomy for rhegmatogenous retinal detachment. Axial lengths were measured using optical biometry and/or ultrasound A-scan. Achieved and predicted refraction were compared to calculate the mean postoperative refractive prediction error and the mean absolute prediction error. Factorial analysis of variance models were developed to assess outcome on the whole and that between the subgroups.

Results: Ninety-five eyes had postoperative refraction: 41 macula-on (43%) and 54 macula-off (57%). The mean postoperative prediction error was -0.34 +/- 0.89 diopters. There was no statistical significant difference in the refractive outcomes between macula-on and macula-off groups (P > 0.05). Overall, using mean absolute prediction error as the outcome measure, optical biometry was more accurate than ultrasound (P = 0.040). However, significantly more ultrasound-measured axial lengths were selected for intraocular lens power estimation in macula-off group compared with the macula-on group (P = 0.016).

Conclusion: Combined phacovitrectomy in rhegmatogenous retinal detachment included a small biometric error that was within the tolerable range in most cases. Both optical biometry and ultrasound should be used to estimate axial lengths, for macula-off rhegmatogenous retinal detachment cases, to improve the accuracy of intraocular lens power calculation.