Prediction of Refractive Error in Combined Vitrectomy and Cataract Surgery With One-Piece Acrylic Intraocular Lens

PURPOSE To compare the predicted and actual refractive errors of hydrophilic, one-piece, C-flex 570C (C-flex) intraocular lens (IOL) implantation in simultaneous vitrectomy and lens extraction in various conditions. METHODS One hundred fifty-nine eyes of patients who had lens extraction between March 2004 and September 2005 were enrolled in a retrospective study. Group 1 had lens extraction and IOL implantation, and Group 2 had lens extraction and IOL implantation with vitrectomy. IOL calculation was done with axial length and keratometry measurements. The actual and predicted refractive errors were compared at 1 and 6 months postoperatively. The factors influencing the postoperative refractive outcomes were analyzed. RESULTS The mean refractive predictive error (i.e., the actual minus predicted spherical equivalent) was +0.19+/-0.39 D (Diopter) and -0.26+/-0.45 D at 1 and 6 months postoperatively (all: p<0.001) in group 1, and -0.22+/-0.39 D and -0.06+/-0.62 D at 1 and 6 months postoperatively (p=0.013, p=0.399 respectively). In group 2, all surgical factors related to refractive errors were not statistically significant (all: p>0.05). CONCLUSIONS Refractive errors in combined surgery showed myopic shift of -0.50 D and -0.32 D at 1 and 6 months postoperatively compared with C-flex IOL implantation alone. With the hyperopic tendency of IOL and myopic tendency of vitrectomy, the combined surgery made postoperative refractive errors near emmetropia.