Embong, Zunaina and Shaharuddin, Bakiah and Noor, Raja Azmi Mohd
(2009)
Preliminary study to compare the prediction error of post operative
refraction in pediatric cataract surgery between 2 different intraocular lens
power calculation formula.
Other.
Pusat Pengajian Sains Perubatan, Universiti Sains Malaysia.
(Submitted)
Abstract
Introduction: The treatment of paediatric cataracts has progressed tremendously in the
past 15 to 20 years. There is a growing trend towards intraocular lens implantation in
infants and younger children whose eyes are still undergoing rapid growth and refractive
changes.
Objective: This study is intended to assess the predictability of desired refractive
outcomes at 3 month postoperative period in paediatric patients undergoing cataract
surgery with primary placement of an intraocular lens.
Methodology: This randomized interventional study of 31 eyes (24 patients) that
successfully underwent cataract surgery and intraocular lens implantations. All patients
were 12 years old and below. Intraocular lens power calculations were made using either
SRK II or Modified Formula For Paediatric IOL Calculation. The postoperative
refractive outcome was taken as the spherical equivalent of the refraction at 3 month
postoperative follow-up. The prediction error was taken as the absolute difference
between the predicted and the actual refraction. The data were analysed to compare the
mean prediction error between SRK II and Modified Formula and evaluate the
predictability.
Results: The mean prediction error in the SRK II group was 1.03 D (SD, 0.69 D) while
in Modified Formula 1.14 D (SD, 1.19 D). The SRK II group showed lower prediction
error of 0.11 D compared to Modified Formula group, but this was not statistically
significant (p > 0.05). There were 3 eyes (18.75%) in SRK II group achieved accurate
predictability where the refraction postoperatively was within ± 0.5 D from predicted
refraction compared to 7 eyes (46.67%) in the Modified Formula group. However the
difference of the predictability between the two formulas was also not statistically
significant (p = 0.097).
Conclusion: The prediction error and the accuracy of predictability of postoperative
refraction in paediatric cataract surgery are comparable between SRK II and Modified
Formula. The existence of the Modified Formula provides an alternative to the
ophthalmologist for intraocular lens calculation in paediatric patients.
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