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Erschienen in:
22.06.2023 | Cataract
Impact of axial length on visual outcomes and complications in phacoemulsification surgery: a multicenter database study
Erschienen in: Graefe's Archive for Clinical and Experimental Ophthalmology | Ausgabe 12/2023
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Purpose
To analyze the impact of axial length (AL) on the visual outcome and rate of perioperative complications in phacoemulsification surgery.
Design
Retrospective clinical database study.
Methods
Cataract surgery data of 217,556 eyes was extracted from the electronic medical records of 8 ophthalmic centers in the United Kingdom from July 2003 to March 2015. A total of 88,774 eyes without ocular co-pathologies were grouped eyes according to AL (mm): short AL (< 22), average AL (22–26; reference group), and long AL (> 26).
Main outcomes and measures
We analyzed visual acuity (VA) outcomes at 4 weeks, 4–12 weeks, and 12–24 weeks postoperatively, as well as the incidence of posterior capsular rupture (PCR), torn iris (TI), cystoid macular edema (CME), and retinal detachment (RD).
Results
Mean pre-operative VA (logMAR) was the worst in eyes with long AL compared to average and short AL eyes (VA 0.59 vs. 0.58 and 0.56; p < 0.001). However, post-operative VA at 4–12 weeks was slightly better in the long AL group (0.14 in short and average AL; 0.12 in long AL, p < 0.001). We observed an increased odds of TI in the short AL group (OR 2.09, 95% CI 1.60–2.75). There was increased risk of RD in long AL eyes (p < 0.001). However, PCR and CME rates were not different.
Conclusion
In the absence of any coexisting ocular pathology, AL alone did not have an impact on VA improvement or the risk of encountering PCR or CME. The risk of TI was greater in the short AL group, and the risk of RD was higher in the long AL group.