Effect of zonular weakness on refractive outcomes of phacoemulsification

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Abstract

BACKGROUND: Zonular weakness caused by pseudoexfoliative syndrome is very common among residents of Northwest Russia. Along with the increasing risk of intraoperative complications, zonular weakness may worsen refractive outcomes of phacoemulsification, as it affects the effective lens position.

AIM: The work aimed to assess the effect of zonular weakness on refractive outcomes of phacoemulsification.

METHODS: The study included data from 282 patients (282 eyes) divided into the following three groups: patients with healthy zonules (n=109; group 1, control), patients with pseudoexfoliative syndrome (n=100; group 2), and patients with grade I lens subluxation caused by pseudoexfoliative syndrome and required capsular tension ring implantation (n=73; group 3). Intraocular lens power was calculated using the SRK/T formula. Optical biometry was performed using IOL-Master 500 device (Carl Zeiss, Germany). The criteria for accuracy of intraocular lens power calculations were the mean calculation error and modulus of the mean calculation error.

RESULTS: The mean calculation errors were 0.00±0.39 D (control), 0.12±0.50 D (group 2), and 0.26±0.59 D (group 3) (p=0.003), indicating a hyperopic shift in groups 2 and 3. The moduli of the mean calculation error were 0.32±0.30, 0.37±0.28, and 0.52±0.45 D, respectively (p <0.001), suggesting lower predictability of refractive outcomes of phacoemulsification in patients with zonular instability.

CONCLUSION: Patients with zonular weakness showed a hyperopic shift caused by a deeper lens position after surgery. To achieve optimal refractive outcomes in this population, A-constant for an intraocular lens should be further optimized.

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About the authors

Dmitrii F. Belov

City Multifield Hospital No. 2; Saint Petersburg State University

Email: belovd1990@gmail.com
ORCID iD: 0000-0003-0776-4065
SPIN-code: 2380-2273

MD, Cand. Sci. (Medicine)

Russian Federation, Saint Petersburg; Saint Petersburg

Vitaly V. Potemkin

City Multifield Hospital No. 2; Academican I.P. Pavlov First St. Petersburg State Medical University

Author for correspondence.
Email: potem@inbox.ru
ORCID iD: 0000-0001-7807-9036
SPIN-code: 3132-9163

MD, Dr. Sci. (Medicine)

Russian Federation, Saint Petersburg; Saint Petersburg

Vadim P. Nikolaenko

City Multifield Hospital No. 2; Saint Petersburg State University

Email: dr.Nikolaenko@mail.ru
ORCID iD: 0000-0002-6393-1289
SPIN-code: 4906-2542

MD, Dr. Sci. (Medicine)

Russian Federation, Saint Petersburg; Saint Petersburg

Bernora O. Ruziboeva

Saint Petersburg State University

Email: st072295@student.spbu.ru
ORCID iD: 0009-0007-1180-6631
Russian Federation, Saint Petersburg

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